Tag: Clinical-Nursing

  • PUB-550 Topic 3: Hypothesis Testing DQs

    PUB-550 Topic 3: Hypothesis Testing DQs

    Topic 3: Hypothesis Testing

    Objectives:

    Evaluate the importance of hypothesis testing in statistics and public health research.

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    Hypothesis Testing

    The purpose of this assignment is to evaluate the steps of hypothesis testing.

    Hypothesis testing is a central component in understanding and interpreting public health research. Research questions are applied through a testable hypothesis established before the data is collected. It provides the rationale for the study and guides the researcher in what tests to use and how to interpret the results. PUB-550 Topic 3: Hypothesis Testing DQs.

    Identify a peer-reviewed article from one of the data sources available on the “Data Resource Document.” You will need to visit the various websites listed on the document to search for a research article that is of interest to you. Include the link to the selected article in a 750-1,000 word summary that address the following as it relates to the article.

    What test statistic did the researchers use? What did the authors set as the significance level of the test statistic?

    What was the null hypothesis? What was the alternative hypothesis? Were these clearly stated in the article, or did you have to extrapolate based on the background in the article? PUB-550 Topic 3: Hypothesis Testing DQs

    Discuss potential bias that may have resulted from the study design and data collection that could have affected the validity of the test.

    Summarize the story told by the data used in this study as it applies to the larger population

    Comment on whether the authors used the interpretation approach discussed in the textbook, including (a) summarize why the study was done, (b) discuss the factual results, (c) explain what the results mean, and (d) make suggestions for future research.

    Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

    This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. PUB-550 Topic 3: Hypothesis Testing DQs

    You are required to submit this assignment to LopesWrite. Refer to the
    LopesWrite Technical Support articles
    for assistance.

    Attachments

    PUB-550-RS-Data Resource Document.docx

    Data Resource Document

    CDC WONDER

    Explore the CDC WONDER website.

    https://wonder.cdc.gov/

    Gapminder

    Explore the Gapminder website.

    Home

    Behavioral Risk Factor Surveillance System

    Explore the Behavioral Risk Factor Surveillance System, located on the CDC website.

    https://www.cdc.gov/brfss/index.html

    PovcalNet

    Explore the PovcalNet: An Online Analysis Tool for Global Poverty Monitoring page of The World Bank website.

    http://iresearch.worldbank.org/PovcalNet/home.aspx

    Demographic and Health Survey Data

    Explore the Demographic and Health Survey (DHS) data website.

    http://dhsprogram.com/data/

    Alcohol-Related Disease Impact Application

    Explore the Alcohol-Related Disease Impact Application (ARDI) page of the CDC website.

    https://nccd.cdc.gov/DPH_ARDI/default/default.aspx

    Public Health Partners

    Explore the Health Data Tools and Statistics page of the Public Health Partners website. This site provides many public health data sources.

    https://phpartners.org/health_stats.html

    National Health Interview Survey

    Explore the National Health Interview Survey page of the CDC website. Review the documents.

    https://www.cdc.gov/nchs/nhis/index.htm

    Global School-Based Student Health Survey

    Explore the purpose and methodology of the international Global School-Based Student Health Survey, located on the World Health Organization (WHO) website.

    http://www.who.int/chp/gshs/en/

    Youth Risk Behavior Surveillance System

    Explore the methods, data, and documentation of the Youth Risk Surveillance System, located on the CDC website.

    https://www.cdc.gov/healthyyouth/data/yrbs/

     

    Topic 3 DQ 1

    Discuss the four potential outcomes of hypothesis testing and describe what is meant by type 1 and type 2 errors. Provide an example of when these errors might occur. PUB-550 Topic 3: Hypothesis Testing DQs

    Topic 3 DQ 1

    Hypothesis testing is used to evaluate a hypothesis about an entire population (Corty, 2016). Hypothesis testing is extremely statistic based with makes it objective not subjective. Statisticians use hypothesis testing to make sure that decisions remain data-based and not emotional based. The data from hypothesis testing is from the sample used to evaluate a population. There are six steps in hypothesis testing (Corty, 2016):

    Pick the right statistical test (TEST)

    Check the assumptions to ensure it is okay to do the test (ASSUMPTION)

    List all null and alternative hypothesis options (HYPOTHESIS)

    Find the value of the static that determines when to reject or accept the null hypothesis (DECISION)

    Calculate the value of the test statistics (CALCULATION)

    State what the results are (INTERPRETATION)

    PUB-550 Topic 3: Hypothesis Testing DQs

    In every hypothesis test, the outcomes are dependent on a correct interpretation of the data (Illowsky, n.d.). Incorrect calculations or misunderstood summary statistics can lead to errors that affect the results. A Type I error occurs when a true null hypothesis is rejected (Illowsky, n.d.). A Type II error occurs when a false null hypothesis is not rejected (Illowsky, n.d.).

    The probabilities of these errors are denoted by the Greek letters α and β, for a Type I and a Type II error respectively (Illowsky, n.d.). The power of the test, 1 – β, quantifies the likelihood that a test will yield the correct result of a true alternative hypothesis being accepted (Illowsky, n.d.). A high power is desirable.

    Formula Review (Illowsky, n.d.).

    α = probability of a Type I error = P(Type I error) = probability of rejecting the null hypothesis when the null hypothesis is true. PUB-550 Topic 3: Hypothesis Testing DQs

    β = probability of a Type II error = P(Type II error) = probability of not rejecting the null hypothesis when the null hypothesis is false.

    The decision is not to reject H0 when H0 is true (correct decision).

    The decision is to reject H0 when H0 is true (incorrect decision known as a Type I error).

    The decision is not to reject H0 when, in fact, H0 is false (incorrect decision known as a Type II error).

    The decision is to reject H0 when H0 is false (correct decision whose probability is called the Power of the Test).

    Example (Illowsky, n.d.):

    It’s a Boy Genetic Labs claim to be able to increase the likelihood that a pregnancy will result in a boy being born. Statisticians want to test the claim. Suppose that the null hypothesis,
    H0
    , is: It’s a Boy Genetic Labs has no effect on gender outcome.

    Type I error:
    This result when a true null hypothesis is rejected. In the context of this scenario, we would state that we believe that It’s a Boy Genetic Labs influences the gender outcome, when in fact it has no effect. The probability of this error occurring is denoted by the Greek letter alpha,
    α
    .

    Type II error:
    This result when we fail to reject a false null hypothesis. In context, we would state that It’s a Boy Genetic Labs does not influence the gender outcome of a pregnancy when, in fact, it does. The probability of this error occurring is denoted by the Greek letter beta,
    β
    . PUB-550 Topic 3: Hypothesis Testing DQs

    References

    Corty, E. (2016). Using and interpreting statistics. A practical text for the behavioral, social, and health sciences 3
    rd
    Edition. Retrieved from
    https://viewer.gcu.edu/GGdEcj

    Illowsky, B. (n.d.). Introduction to Statistics. Retrieved from https://courses.lumenlearning.com/introstats1/chapter/outcomes-and-the-type-i-and-type-ii-errors/

     

    opic 3 DQ 1

    Banerjee et al., (2009) study found the following: Hypothesis testing is an important activity of empirical research and evidence-based medicine. A well worked up hypothesis is half the answer to the research question. For this, both knowledge of the subject derived from extensive review of the literature and working knowledge of basic statistical concepts are desirable. The present paper discusses the methods of working up a good hypothesis and statistical concepts of hypothesis testing (p.127)

    Banerjee et al., (2009) study found the following: Just like a judge’s conclusion, an investigator’s conclusion may be wrong. Sometimes, by chance alone, a sample is not representative of the population. Thus, the results in the sample do not reflect reality in the population, and the random error leads to an erroneous inference. A type I error (false-positive) occurs if an investigator rejects a null hypothesis that is actually true in the population; a type II error (false-negative) occurs if the investigator fails to reject a null hypothesis that is actually false in the population. Although type I and type II errors can never be avoided entirely, the investigator can reduce their likelihood by increasing the sample size (the larger the sample, the lesser is the likelihood that it will differ substantially from the population) (p.127). PUB-550 Topic 3: Hypothesis Testing DQs

    Banerjee et al., (2009) study found the following: False-positive and false-negative results can also occur because of bias (observer, instrument, recall, etc.). (Errors due to bias, however, are not referred to as type I and type II errors.) Such errors are troublesome, since they may be difficult to detect and cannot usually be quantified (p.127).

     

     

    Reference

    Banerjee, A., Chitnis, U. B., Jadhav, S. L., Bhawalkar, J. S., & Chaudhury, S. (2009). Hypothesis testing, type I and type II errors.
    Industrial psychiatry journal
    ,
    18
    (2), 127–131. doi:10.4103/0972-6748.62274

     

    Topic 3 DQ 2

    Review the Healthy People 2020 website. Identify one of the health issues and propose a scenario that would use a z-test as the first step in the six steps of hypothesis testing. Discuss the remaining five steps based on your scenario, including clearly articulating the null and alternative hypotheses for your scenario.

    Topic 3 DQ 2

    Topic Three, Discussion Question Two.This assignment requires visiting the Healthy People 2020 website and identify one health issue and propose a scenario that would use a z-test as the first step in the six steps of hypothesis testing. Last, discuss the remaining five steps based on your scenario, including clearly articulating the null and alternative hypotheses for the scenario. PUB-550 Topic 3: Hypothesis Testing DQsHypothesis testing is used to evaluate a hypothesis about an entire population (Corty, 2016). Hypothesis testing is extremely statistic based with makes it objective not subjective. Statisticians use hypothesis testing to make sure that decisions remain data-based and not emotional based. The data from hypothesis testing is from the sample used to evaluate a population. There are six steps in hypothesis testing (Corty, 2016):

     

    Pick the right statistical test (TEST)

    Check the assumptions to ensure it is okay to do the test (ASSUMPTION)

    List all null and alternative hypothesis options (HYPOTHESIS)

    Find the value of the static that determines when to reject or accept the null hypothesis (DECISION)

    Calculate the value of the test statistics (CALCULATION)

    State what the results are (INTERPRETATION)

    Now that we have defined hypothesis testing let’s understand what a z-test is. It is a type of hypothesis test that is used when (Statistics How To, 2018): PUB-550 Topic 3: Hypothesis Testing DQs

    The sample size is greater than 30

    Data points are independent from each other (one data point isn’t related or doesn’t affect another data point)

    The data should be normally distributed

    The data should be randomly selected from a population, where each item has an equal chance of being selected.

    The sample size should be equal if at all possible.

    When running a z-test with the data – there are five steps that are required (Statistics How To, 2018):

    State a null and alternate hypothesis

    Choose an alpha level

    Find the critical value of “z” in the z table

    Calculate the z test statistic

    Compare the test statistic to the critical z value and decide if you shoul support or reject the null hypothesis

    After reviewing the Healthy People 2020 website, the health issue I have decided to pin-point is childhood obesity. One scenario that would use a z-test as the first hypothesis step in a scenario that would use a z-test as the first step in the six steps of hypothesis testing is kids eating fast food multiple times a week impact childhood obesity.

    To do this scenario we would have two different proportion ztests that will allow us to compare the two proportions to see if they are the same or different. As stated above:

    The null hypothesis (H
    0
    ) for the test is that the proportions are the same. – Yes, survey results and data (weight measurements combined) show that children that eat out three times a week with fast food gain weight faster than those who do not eat out. PUB-550 Topic 3: Hypothesis Testing DQs

    The alternate hypothesis (H
    1
    ) is that the proportions are
    not
    the same. The survey results and the data do not show that eating out three times a week with fast food support weight gain in children.

    Now that we have the right statistical test (z-test) we need to make sure the rest of the hypothesis testing is ready to go.

    Check the assumptions to ensure it is okay to do the test (ASSUMPTION)

    List all null and alternative hypothesis options (HYPOTHESIS) – listed above.

    Find the value of the static that determines when to reject or accept the null hypothesis (DECISION)

    Calculate the value of the test statistics (CALCULATION)

    State what the results are (INTERPRETATION)

    References

    Corty, E. (2016). Using and interpreting statistics. A practical text for the behavioral, social, and health sciences 3
    rd
    Edition. Retrieved from
    https://viewer.gcu.edu/GGdEcj

    Statistics How To. (2018). Z Test: Definition & Two Proportion Z-Test. Retrieved from https://www.statisticshowto.datasciencecentral.com/z-test/ PUB-550 Topic 3: Hypothesis Testing DQs

  • PUB-550 Topic 2: Probability and Confidence Intervals discussion questions

    PUB-550 Topic 2: Probability and Confidence Intervals discussion questions

    Topic 2: Probability and Confidence Intervals

    Objectives:

    Apply descriptive statistics to describe qualitative and quantitative characteristics of a sample.

    Demonstrate how probability and normal distribution are used to determine significance.

    Apply a sample standard deviation to describe a variable and its dispersion.

    Explain the central theorem limit.

    Evaluate the application of confidence intervals in public health research.

    PUB-550 Topic 2: Probability and Confidence Intervals discussion questions

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    Topic 2 DQ 1

    P-values and confidence intervals are both used in hypothesis testing. Explain three reasons why it may be preferable to report a confidence interval over a P-value. Provide a specific example to justify your reasons.

    Topic 2 DQ 1

    The use of P-values and Confidence Intervals (CIs) are important for understanding evaluations of scientific studies. Specifically, they are used in evaluating hypothesis testing. A P value is the core of statistical inference method but is limited to dichotomous evaluation whether null is statistically significant or not (Lee, 2016). An alternative approach that is more informative that P value is confidence intervals. Whereas with P values an investigator could state P<0.05 or P >0.05, there is little information about the direction or size of the differences (Gardner & Altman, 1986). CIs gives a greater amount of information of the magnitude and precision of the measurement.

    The first reason that confidence intervals may be preferable over P-values is that confidence intervals are interval estimates for population value rather than a single point value. Researchers are able to take a sample from a larger population, calculate the sample mean, and construct a range (Confidence interval), that has a greater probability of containing the population mean than a point estimate (Corty, 2016).

    The second reason confidence intervals may be preferable over P-values, is that they are not limited to dichotomous significant or not significant, but rather are able to provide the magnitude of the effect. A 95% confidence interval means that the population mean is within the range of 95% of confidence interval of the calculated mean with a probability of 95% (Lee, 2016). With the increase of sample size, the confidence interval narrows while limits of significance remain unchanged. For example, statistical results that may have the same P-value, the estimated confidence interval narrows with a larger sample size indicating a more reliable result (Lee, 2016). PUB-550 Topic 2: Probability and Confidence Intervals discussion questions.

    The third reason confidence intervals may be preferable over P-values, is that p values enable recognition of statistically noteworthy findings, whereas confidence intervals provide information about the range in which the true value of the population lies within a certain degree of probability, as well as direction and strength of the effect (du Prel, Hommel, Rohrig, &Blettner, 2009) PUB-550 Topic 2: Probability and Confidence Intervals discussion questions. The smaller the P-value the more statistically significant and stronger the evidence is. Confidence intervals reflect results at the level of data measurement, and include the desired parameter within a certain probability (du Prel et al., 2009).

     

    References

    Corty, E. Using and interpreting statistics: A practical text for behavioral, social, and health sciences (3rd ed.). New York, NY: Macmillan Learning.

    du Prel, J-B., Hommel, G., Rohrig, B., & Blettner, M. (2009). Confidence interval or P-value
    . Deutschees Arzteblatt International, 106
    (19), 335-339. doi: 10.3238/arztebl.2009.0335 PUB-550 Topic 2: Probability and Confidence Intervals discussion questions

    Gardner, M. J. & Altman, D. G. (1986). Confidence intervals rather than P values: estimation rather than hypothesis testing.
    British Medical Journal
    , 292, 746-750. Retrieved from
    https://www.bmj.com/content/bmj/292/6522/746.full.pdf

    Lee, D. K. (2016). Alternatives to P value: confidence interval and effect size.
    Korean Journal of Anesthesiology
    , 69(6), 555-562. doi: 10.4097/kjae.2016.69.6.555

     

    Topic 2 DQ 2

    During the simulation the results of increasing the sample size really didn’t change the curve at all. The central limit theorem demonstrates how much sampling error exists in samples by taking repeated random samples from a population, calculating the mean for each sample and then making a frequency distribution of the mean (Corty, 2016). The theory predicts that the standard error of the mean can be calculated if one knows the population standard deviation and the size of the sample (Corty, 2016). The theory also predicts that the sampling distribution is normally distributed, and the mean of the sampling distribution is the mean of the population (Corty, 2016).

    I found this example from an unofficial source, but I found it descriptive – Find an old stone step or lintel in front of a doorway (one that is old enough that it has been worn down by generations of people walking over it). If you look at how it is worn down, the wearing down won’t be uniform over the surface of the step: rather, it will be in a bell-curve. (People tend to walk through the middle of the doorway.) If the door doesn’t open all the way, the bell-curve won’t be perfect; there will a bias towards the side away from the hinges”. For some reason this helped cement the theory for me, the bell curve is “where most of the samples walk through the doorway”. PUB-550 Topic 2: Probability and Confidence Intervals discussion questions

    References

    Cool Examples of Central Limit Theorem in Action. Retrieved from
    https://math.stackexchange.com/questions/38825/cool-examples-of-the-central-limit-theorem-in-action
    .

    Corty, E. W. (2016).
    Using and Interpreting Statistics.
    New York: Worth Publishers . PUB-550 Topic 2: Probability and Confidence Intervals discussion questions

  • PUB-550 Calculating Confidence Intervals

    Calculating Confidence Intervals

    The purpose of this PUB-550 Calculating Confidence Intervals assignment is to practice calculating confidence intervals.

    For this assignment, students will utilize Excel and SPSS Statistics and the “Example Dataset.”

    Using the “Example Dataset,” complete the following:

    Based on a normal distribution curve, calculate the probability of an individual being 60 years or older in this population. Show the Excel and SPSS formulas or your hand calculations. Include screenshots as needed to illustrate this.

    Using the sample standard deviation of age as an estimate of the population standard deviation, calculate by hand the standard error of the mean. Show your calculations and the answer.

    Calculate by hand a 95% confidence interval for “Age” based on the sample mean. Use SPSS to verify your answer. Include your calculations and screenshots of the SPSS output. PUB-550 Calculating Confidence Intervals

    Interpret the confidence interval for age and explain the three pieces of information needed to calculate a confidence interval.

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    Submit one Word document that includes all of the assignment deliverables.

    APA style is not required, but solid academic writing is expected.

    This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

    You are not required to submit this assignment to LopesWrite. PUB-550 Calculating Confidence Intervals

    Attachments

    PUB-550-RS-Example Dataset.xlsx

  • PUB-550 Practicing Application of Descriptive Statistics in Excel and SPSS

    Practicing Application of Descriptive Statistics in Excel and SPSS

    The purpose of this PUB-550 Practicing Application of Descriptive Statistics in Excel and SPSS assignment is to compare basic functions in Excel and SPSS to calculate descriptive statistics and use this information to describe the sample.

    For this assignment, students will utilize Excel with the Data Analysis ToolPak and SPSS Statistics and the “Example Dataset” to complete the assignment. Refer to the Topic Materials for assistance with enabling the Data Analysis ToolPak on a Mac or PC.

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    Part 1:

    Complete the following steps in both Excel and IBM SPSS Statistics.

    Calculate mean, median, and mode for the variables “Annual Income” and “Age.” Show the appropriate summary tables for these measures from both Excel and SPSS. Include the other descriptive statistics that are a part of the summary output in Excel and SPSS.

    Create histograms to show the distribution for “Annual Income” and “Age.” Copy and paste the histograms from Excel and export the histogram from SPSS into the Word document for this assignment.

    Create frequency tables that include counts and percentages for smoking status, employment status, exercise level, and education level. Show the tables in the Word document for this assignment.

    PUB-550 Practicing Application of Descriptive Statistics in Excel and SPSS

    Part 2:

    Based upon the Part 1 activities, write a 250-500 word interpretation that addresses the following.

    Discuss the sampling strategy used in this study and if it resulted in a representative sample.

    Discuss what you are able to ascertain about the sample from the descriptive statistics.

    Explain what other variables the research team could have included to gain a better understanding of the population.

    General Requirements

    Submit one Word document for the Part 1 assignment content and a second Word document for Part 2 of the assignment.

    APA style is not required, but solid academic writing is expected. PUB-550 Practicing Application of Descriptive Statistics in Excel and SPSS

    This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

    You are not required to submit this assignment to LopesWrite. PUB-550 Practicing Application of Descriptive Statistics in Excel and SPSS

    Attachments

    PUB-550-RS-Example Dataset.xlsx

  • nurs 623 mnemonics

    nurs 623 mnemonics

    MONA

    M-Morphine

    O-Oxygen

    N-Nitrates

    A-Aspirin (ASA)

    Description

    The treatment protocol for angina is morphine, oxygen, nitroglycerin, and aspirin. Morphine works to decrease pain and difficulty breathing, oxygen ensures that poorly oxygenated tissues receive the required oxygen, nitroglycerin is a potent vasodilator and aids in restoring oxygenation to tissues, aspirin helps to thin the blood and increase tissue perfusion.

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    CRAM

    C-Color/Cap refill

    R-Reduce BP

    A-Assess peripheral pulses

    M-Monitor renal function/labs

    Description

    The therapeutic management for a patient with aortic aneurysm.

    Pee BADS

    P-Pain

    B-Back

    A-Abdomen

    D-Dyspnea

    S-Shoulders

    Description

    Symptoms you would find for a patient with a thoracic aortic aneurysm. Pain in the Back, Abdomen, or shoulders with dyspnea. nurs 623 mnemonics.

    SAD

    S-Syncope

    A-Angina

    D-Dyspnea

    Description

    Symptoms of aortic stenosis.

    BE JOAN OF ARC

    B-Blood culture positive

    E-Echo evidence of vegetation

    J-Janeway lesion

    O-Oslers node

    A-Aneurysm (mycotic); Abuse(substance)

    N-Nephritis

    O-Other predisposing heart condition

    F-Fever

    A-Arterial emboli

    R-Roth’s spot; Rheumatoid factor

    C-Culture positive not meeting major criteria

    Description

    The major and minor criteria of endocarditis

    Toilet Paper My Ass

    T-Tricuspid

    P-Pulmonic

    M-Mitral

    A-Aortic

    Description

    This simple mnemonic helps to remember the order in which blood passes through the four heart valves in sequential order. nurs 623 mnemonics.

    The 5 P’s

    P-Pain

    P-Paresthesia

    P-Paralysis

    P-Pulse

    P-Pallor (Paleness)

    Description

    Check for the 5 P’s in every neurovascular check. For example, when the patient has a cast, or had some sort of orthopedic or vascular procedure

    I have a RIGHT to CAMP if you LEFT off the AC

    Right

    C-coronary

    A-artery

    M-marginal artery

    P-posterior intraventricular artery

    Left

    A-anterior descending artery

    C-circumflex artery

    Description

    Locations of the different coronary arteries on the right and left sides

    Please Read His Text

    P-Peripheral edema

    R-Raised JVP

    H-Hepatomegaly

    T-Tricuspid incompetence

    Description

    Cor pulmonale is an enlargement of the right side of the heart caused by a problem with the lungs or pulmonary vessels. This pneumonic represents the symptoms

    UNLOAD FAST

    U-sit Upright

    N-Nitro

    L-Lasix

    O-Oxygen

    A-Aminophylline

    D-Digoxin

    F-Fluids – decrease

    A-Afterload – decrease

    S-Sodium – decrease

    T-Tests: dig level, ABG, K+

    Description

    These treatments used in conjunction will help in reducing the symptoms and complications associated with CHF.

    The 4 T’s

    T-Tetralogy of Fallot

    T-Truncus Arteriosus

    T-Transposition of the Great Vessels

    T-Tricuspid Atresia

    Description

    Cyanotic heart defects are a group of congenital heart defects that result from deoxygenated blood by-passing the lungs and going into systemic circulation. Tetralogy of Fallot includes 4 anatomical abnormalities that are pictured below. Truncus Arteriosus is a condition where the pulmonary trunk and aorta don’t properly divide in development. This results in one large vessel carrying mixed blood to the heart, lungs, and systemic circulation. Transportation of the Great Vessels is a condition where vessels are swapped or may be in abnormal positions. Tricuspid Atresia is a condition where there is no tricuspid valve, which leads to an undersized or absent right ventricle.

    CHOP

    C-Cough

    H-Hemoptysis

    O-Orthopnea

    P-Pulmonary Congestion (crackles/rales)

    Description

    Left sided heart failure will primarily manifest as pulmonary edema as the left side of the heart moves blood from the lungs throughout the body. If this portion of the pump is broken the blood will become “backed up” within the lungs. Left sided heart failure can often lead to right sided heart failure.

    LEFT – LUNG | RIGHT – REST

    L-LEFT side of the heart

    L-LUNG has edema

    R-RIGHT side of the heart

    R-REST of the body has edema

    Description

    A hint for remembering which side of HF has which complications. The LEFT side of the heart if the LUNG has edema (crackles, abnormal lung sounds) or the RIGHT side of the heart if the REST of the body has edema (hands, feet, literally anywhere else)

    HEAD

    H-Hepatomegaly

    E-Edema (Bipedal)

    A-Ascites

    D-Distended Neck Veins

    Description

    Right sided heart failure will primarily manifest as central edema as the right side of the heart takes fluid from the body and moves it forward. If this portion of the pump is broken, fluid will become “backed up” behind the pump and therefore within the body. nurs 623 mnemonics.

    APE To Man

    A-Aortic

    P-Pulmonic

    E-Erbs points

    T-Tricuspid

    M-Mitral

    Description

    Aortic and Pulmonic (A&P): 2 words, 2 spaces; these coincide in that they are both in the 2nd intercostal space. A is immediately to the right of the sternum, P is immediately to the left of the sternum. Erb’s point: Erb has 3 letters; you can find this point in the 3rd intercostal space (just to the left of the sternum), also the 3rd space to auscultate Tricuspid: 5th intercostal, just to the left of the sternum. Tri = 3, this is the fourth place to auscultate in the 5th intercostal space! Mitral: Mit sounds similar to mid.. Midclavicular area and straight down just below nipple line.

    The 4 C’s

    C-Coronary Artery Disease

    C-Coronary Rheumatic Fever

    C-Congestive Heart Failure

    C-Cerebral Vascular Accident

    Description

    Complications of untreated hypertension

    DIURETIC

    D-Daily Weight

    I-Intake and Output (I & O)

    U-Urine Output

    R-Response of BP

    E-Electrolytes

    T-Take Pulses

    I-Ischemic Episodes (TIA)

    C-Complications: The 4 Cs on Hypertension

    Description

    For patients with elevated blood pressure, monitor daily weights, intake and output, and urine output to watch for fluid retention. Monitor blood pressure and pulse in response to treatments. Diuretics may cause increased loss of electrolytes in the urine.

    VAK

    V-Vasopressers

    A-Avoid vagal maneuvers

    K-Keep MAP > 80

    Description

    To increase mean arterial presure a nurse can use vasopressors, avoid vagal maneuvers, and keep MAP above 80

    hARD ASS MRS. MSD

    hARD: Aortic Regurg = Diastolic

    ASS: Aortic Stenosis = Systolic

    MRS: Mitral Regurg = Systolic

    MSD: Mitral Stenosis = Diastolic

    Description

    Help remembering on which phase of heart contraction you would hear a murmur

    MONATAS

    M-Morphine

    O-Oxygen

    N-Nitrates

    A-Aspirin (ASA)

    T-Thrombolytics

    A-Anticoagulants

    S-Stool Softeners

    Description

    Interventions for the Management of MI

    TV SPARC CUBE

    T-Thirst

    V-Vomiting

    S-Sweating

    P-Pulse weak

    A-Anxious

    R-Respirations shallow/rapid

    C-Cool

    C-Cyanotic

    U-Unconscious

    B-BP low

    E-Eyes blank

    Description

    Mnemonic to help you remember the signs and symptoms of shock

    TV SPARC CUBE

    T-Thirst

    V-Vomiting

    S-Sweating

    P-Pulse weak

    A-Anxious

    R-Respirations shallow/rapid

    C-Cool

    C-Cyanotic

    U-Unconscious

    B-BP low

    E-Eyes blank

    Description

    Mnemonic to help you remember the signs and symptoms of shock

    HIS Leg Might Fall off

    H-History of DVT in the past

    I-Immobility

    S-Surgery

    L-Leg: varicose veins

    M-Malignancy

    F-Fracture

    Description

    The risk factors for developing a DVT for patients.

    COLD HAND

    C-Cryoglobulins/ Cryofibrinogens

    O-Obstruction/ Occupational

    L-Lupus erythematosus, other connective tissue disease

    D-Diabetes mellitus/ Drugs

    H-Hematologic problems (polycythemia, leukemia, etc)

    A-Arterial problems (atherosclerosis)

    N-Neurologic problems (vascular tone)

    D-Disease of unknown origin (idiopathic

    Description

    Symptoms of Raynaud’s disease.

    Triple “H” Therapy

    H-Hypertension

    H-Hypervolemia

    H-Hemodilution

    Description

    Therapy for a vasospasm that occurs as a complication due to hemorrhagic stroke

    KULT

    K-Ketoacidosis

    U-Uremia

    L-Lactic Acidosis

    T-Toxins

    Description

    An anion gap acidosis occurs when the substances responsible for causing metabolic acidosis are unmeasurable or not indicated by anions or cations (i.e. electrolytes). This mnemonic provides some general situations that would produce an anion gap acidosis. nurs 623 mnemonics.

    MUDPILES

    M-Methanol

    U-Uremia

    D-Diabetic ketoacidosis

    P-Paracetamol, Propylene glycol

    I-Infection, Iron, Isoniazid

    L-Lactic acidosis

    E-Ethylene glycol

    S-Salicylates

    Description

    An anion gap acidosis occurs when the substances responsible for causing metabolic acidosis are unmeasurable or not indicated by anions or cations (i.e. electrolytes). This mnemonic provides some specific conditions that would produce an anion gap acidosis.

    ROME

    R-Respiratory

    O-Opposite

    M-Metabolic

    E-Equal

    Description

    First look at the pH: if it is low it is acidosis, high indicates alkalosis. Second use the ROME mnemonic to determine if you have respiratory vs. metabolic. For Metabolic look at HCO3. For Respiratory, look at pCO2.

    Metabolic Acidosis – pH Low, HCO3 Low. Metabolic Alkalosis – pH High, HCO3 High. Respiratory Acidosis – pH Low, pCO2 High. Respiratory Alkalosis – pH High, pCO2 Low.

    Universally Odd

    U-Universal Donor

    O-Only receive from O

    Description

    Picture Type O as a huge circle, like the universe, because they are the universal donor. They can give to everyone. However, also think of them as the “odd man out” because they can only receive type O as well. They are universally odd, able to give to all but only receive from themselves!

    PISO

    P-Potassium

    I-Inside the cell

    S-Sodium

    O-Outside the cell

    Description

    Potassium and sodium are the two most abundant cations in the body and have an inverse relationship in regards to intracellular and extracellular concentrations. Potassium is primarily located within the cell and sodium is primarily located outside the cell.

    GROANS, MOANS, BONES, STONES, OVERTONES

    GROANS-Constipation

    MOANS-Joint pain

    BONES-Loss of calcium from bones

    STONES-Kidney stones

    OVERTONES-psychiatric overtones (confusion, depression)

    Description

    The BONES store the most calcium – remember these words that rhyme with BONES to help you remember possible signs and symptoms of hypercalcemia.

    MACHINE

    M-Medications – ACE Inhibitors, NSAIDS, potassium-sparing diuretics

    A-Acidosis – Metabolic and respiratory

    C-Cellular destruction – burns, traumatic injury, hemolysis

    H-Hypoaldosteronism – Addison’s

    I-Intake- excessive

    N-Nephrons- renal failure

    E-Excretion – Impaired

    Description

    Hyperkalemia is elevated potassium in the blood. Typical levels of potassium in the blood are 3.5 to 5.0 mEq/L. In acidosis and cellular destruction, potassium shifts from inside the cell to the blood stream. Medications and kidney damage can decrease urinary excretion of potassium. Excessive intake of potassium can also lead to hyperkalemia. Potassium is necessary for the transmission of electrical impulses in heart and skeletal muscle; therefore increased potassium can cause ECG changes.

    Dry & Hot – Insulin Shot

    HIGH-Dry & Hot – Insulin Shot

    Description

    During hyperglycemia, a patient is dehydrated with elevated blood sugars. You can also remember “High and Dry”

    AIRED

    A-Administer IV Calcium – to immediately decrease cardiac toxicity

    I-Increase excretion – via both stool (kayexlate) and urine (diuretics)

    R-Remove sources of potassium – from all sources, including enteral, pareteral, IV, and PO

    E-Enhance potassium uptake into cells – insulin, glucose, sodium bicarb, beta-adrenergic antagonists

    Dialysis – emergent response for patients with lethal hyperkalemia

    Description

    Remember the word AIRED to know what interventinos are used to manage hyperkalemia. The ultimate goal is to reduce the amount of circulating potassium and to protect the heart from the dangerous effects of hyperkalemia

    MURDER

    M-Muscle weakness

    U-Urine- oliguria, anuria

    R-Respiratory distress

    D-Decreased cardiac contractility

    E-ECG changes

    R-Reflexes- hyperreflexia, or areflexia (flaccid)

    Description

    Excess potassium is deadly and can kill a patient – so remember the word “Murder”. This will help you remember the signs and symptoms of hyperkalemia. nurs 623 mnemonics.

    MODEL

    M-Medications / Meals

    O-Osmotic diuretics

    D-Diabetes insipidus

    E-Excessive water loss

    L-Low water intake

    Description

    Think “Salt Modeling Agency” – Use the word MODEL to remember the causes of hypernatremia

    SALT

    S- Skin flushed

    A-Agitation

    L-Low grade fever

    T-Thirst

    Description

    Sodium is the primary component in table salt. the word SALT can help you remember the signs and symptoms of Hypernatremia

    CATS

    C-Convulsions

    A-Arrhythmias

    T-Tetany

    S-Spasms and stridor

    Description

    Hypocalcemia is low levels of calcium in the blood. Large of stores of calcium are in the bone. Calcium blocks sodium channels, inhibiting depolarization of muscle and nerve fibers. The effects of hypocalcemia are a result of muscle fibers being more excitable.

    TIRED

    T-Tachycardia

    I-Irritability

    R-Restless

    E-Excessive Hunger

    D-Diaphoresis / Depression

    Description

    During hypoglycemia the serum glucose level is too low. Cells of the body can’t get adequate energy supply when there is not enough sugar in the blood. You will feel TIRED and have the symptoms listed above.

    6 L’s

    L-Lethargy

    L-Leg cramps

    L-Limp muscles

    L-Low, shallow respirations

    L-Lethal cardiac dysrythmias

    L-Lots of urine (polyuria)

    Description

    Hypokalemia is LOW potassium, which starts with L. So the 6 L’s can help you recognize the signs and symptoms of LOW potassium or hypokalemia

    SALT LOSS

    S-Stupor/coma

    A-Anorexia, N&V

    L-Lethargy

    T-Tendon reflexes decreased

    L-Limp muscles (weakness)

    O-Orthostatic hypotension

    S-Seizures/headache

    S-Stomach cramping

    Description

    Hyponatremia is decreased levels of sodium in the blood. It can be caused by inadequate sodium or excess free water which leads to lower concentration of sodium. Sodium and potassium work together to allow depolarization of muscles. Low sodium levels can limit this ability and cause muscle weakness. Sodium in the blood helps maintain the oncotic pressure. If fluid leaves the blood vessels, it can lead to decreased blood pressure.

    All Dogs Eat Kibble

    A-Vitamin A

    D-Vitamin D

    E-Vitamin E

    K-Vitamin K

    Description

    Vitamins A, D, E, and K are all fat soluble vitamins. Dogs get fat eating too much kibble

    Birth Control

    B-Vitamin B

    C-Vitamin C

    Description

    To remember which vitamins are water soluble, remember that you take your Birth Control with water. So, Vitamins B and C are water soluble. The rest of the vitamins are fat soluble.

    CLPN

    C-Carbs

    L-Lipids

    P-Proteins

    N-Nucleic acids

    Description

    CLPN Mnemonic to remember macromolecules: Carbs, lipids, proteins, nucleic acids

    CHO, CHO, CHON

    Lipids:

    C-Carbon

    H-Hydrogen

    O-Oxygen

    Carbohydrates:

    C-Carbon

    H-Hydrogen

    O-Oxygen

    Protein:

    C-Carbon

    O-Oxygen

    H-Hydrogen

    N-Nitrogen

    Description

    This teaches the elements that makeup lipids, carbohydrates, and proteins respectively

    BROW

    B-Barley

    R-Rye

    O-Oats

    W-Wheat

    Description

    Gluten is a protein found in wheat, barley and rye. People with gluten allergies can be affected by even trace amount of gluten in foods. If they don’t feel good, they’ll furrow their BROW. Oats do not contain gluten, but they are often milled in the same factories as wheat. Always check food labels to make sure a product is gluten free.

    Never Carry Dirty Socks Or Smelly Clothes

    N-Normal

    C-Confused

    D-Delerious

    S-Somnolent

    O-Obtunded

    S-Stuporous

    Comatose

    Description

    The different levels of consciousness that range from normal to comatose, in order.

    ANOREXIA

    A-Amenorrhea

    N-No organic factors accounts for weight loss

    O-Obviously thin but feels FAT

    R-Refusal to maintain normal body weight

    E-Epigastric discomfort is common

    X-X-symptoms (peculiar symptoms)

    I-Intense fears of gaining weight

    A-Always thinking of food

    Description

    Anorexia nervosa is an eating disorder characterized by low body weight and periods of starvation or binging and purging. The lack of adequate nutrition and fat stores can lead to amenorrhea. Patients with anorexia will feel fat even if underweight, as anorexia is an unhealthy way to cope with emotional problems. Binging and purging can lead to damage of the GI tract and epigastric discomfort. Some peculiar symptoms may also be seen: abnormal blood counts, bluish discoloration of the fingers, hair that thins, breaks or falls out, or soft downy hair covering the body.

    PAINS

    P-Pain in the right lower quadrant of the abdomen

    A-Anorexia-loss of appetite

    I-Increased temperature, WBC (15,000-20,000)

    N-Nausea

    S-Signs (McBurney’s, Psoas)

    Description

    Appendicitis-Psoas sign is pain when a patient extends their thigh while lying on their side with knees extended. It indicates irritation to certain abdominal muscles.

    McBurney’s sign is if there is deep tenderness at McBurney’s point, which is located on the right side of the abdomen, one-third the distance from the anterior superior iliac spine to the navel.

    BULIMIA

    B-Binge eating

    U-Under strict dieting

    L-Lacks control/over-eating Induced vomiting

    M-Minimum of two binge eating episodes

    I-Increase/Persistent concern of body size/shape

    A-Abuse of diuretics and laxatives

    Description

    Bulimia is an eating disorder characterized by binging and purging. Patients may go through periods of excessive eating and then try to purge be inducing vomiting, taking laxatives or diuretics, or going through periods of fasting.

    WASHED

    W-Weight loss of 15% of original body weight

    A-Amenorrhea

    S-Social withdrawal

    H-History of high activity and achievement

    E-Electrolyte imbalance

    D-Depression / Distorted Body Image

    Description

    Bulimia is an eating disorder characterized by binging and purging. Patients may go through periods of excessive eating and then try to purge be inducing vomiting, taking laxatives or diuretics, or going through periods of fasting. Because they can be malnourished, they may look “Washed out”

    CHRISTMAS

    C-Cobblestones

    H-High temperature

    R-Reduced lumen

    I-Intestinal Fistulae

    S-Skip lesions

    T-Transmural (all layers)

    M-Malabsorption

    A-Abdominal pain

    S-Submucosal fibrosis

    Description

    Morphology and symptoms related to Crohn’s

    Please Bring Happy Energy

    P-Portal hypertension

    B-Bleeding risk

    H-Hepatic Encephalopathy

    E-Esophageal varices

    Description

    Complications of liver cirrhosis

    BAD HITS

    B-Biliary

    A-Alcohol

    D-Drugs

    H-Hypertryglyceridemia

    I-Idiopathic

    T-Trauma

    S-Scorpian sting

    Description

    Common causes of pancreatitis

    BRAT

    B-Banana

    R-Rice

    A-Apple

    T-Toast

    Description

    The BRAT diet is a bland diet that is low in protein, fiber, and fat. It is thought to be easy on the GI tract and helpful to lesson diarrhea. It is not used commonly anymore because of the lack of protein in the diet.

    Please Fix His Abscess SOon

    P-Perforation

    F-Fistulae

    H-Hemorrhage

    A-Abscess

    SO-Strictures/Obstructions

    Description

    Complications of diverticulitis

    AIR RAID

    A-Airway Closed

    I-Increased Pulse

    R-Restlessness

    R-Retractions- occur when the muscles between the ribs pull inward

    A-Anxiety

    I-Increased Inspiratory Stridor- high-pitched breath sound resulting from turbulent airflow in the larynx

    D-Drooling

    Description

    The epiglottis is a flap of cartilage that covers the entrance to our airway when we swallow food. Inflammation of the epiglottis can close off the airway entirely.

    Reflux Is Probably Mean

    R-Relaxed or incompetent lower esophogeal sphincter

    I-Increased gastric volume

    P-Pyloric stenosis

    M-Motility disorder

    Description

    There are several common causes that could lead to the diagnosis of GERD

    Her Belly Really Hurts Following Dinner

    H-Heartburn

    B-Bowel Sounds Over Chest

    R-Regurgitation

    H-Hiccups

    F-Fullness

    D-Dysphagia

    Description

    Symptoms of a Hiatal Hernia

    ORDER A PLAGIARISM-FREE PAPER HERE

    5-Fs

    F-Female

    F-Fat

    F-Fertile

    F-Forty

    F-Fair (skin)

    Description

    Common risk factors associated with gallstones

    The 3 C’s

    C-Choking

    C-Coughing

    C-Cyanosis

    Description

    A tracheal esophageal fistula (TEF) is a congenital abnormality in which there is an opening between the trachea and the esophagus. Surgery is required to repair the opening before a baby can receive oral nutrition. Signs and symptoms to identify TEF are choking, coughing, and cyanosis.

    PIE

    P-Prolapsed

    I-Internal

    E-External

    Description

    The three types of hemorrhoids

    MADE 10

    M-Malnurition

    A-Anorexia

    D-Dehydration

    E-Electrolyte Imbalances

    10-10-20 stools per day

    Description

    Assessment findings for ulcerative colitis

    CAUTION UP

    C-Change in bowel or bladder

    A-A lesion that does not heal

    U-Unusual bleeding or discharge

    T-Thickening or lump in breast or elsewhere

    I-Indigestion or difficulty swallowing

    O-Obvious changes in wart or mole

    N-Nagging cough or persistent hoarseness

    U-Unexplained weight loss

    P-Pernicious Anemia

    Description

    Cancer can sometimes be difficult to identify, but the earlier it is detected the better chance treatment will be effective.

    CANCER

    C-Comfort

    A-Altered Body Image

    N-Nutrition

    C-Chemotherapy

    E-Evaluate response to meds

    R-Respite for caretakers

    Description

    These are the top nursing priorities for a patient with CANCER

    ABCDE

    A-Asymmetry- is the mole irregular in shape?

    B-Border- is the border irregular, notched, or poorly defined?

    C-Color- does the color vary (for example, between shades of brown, red, white, blue, or black)?

    D-Diameter- is the diameter more than 6 mm?

    E-Elevation or Evolution – is it raised or has it changed in the last 6 months

    Description

    Evaluation of irregular moles that could possibly be cancerous

    ANT

    A-Anemia

    N-Neutropenia

    T-Thrombocytopenia

    Description

    Leukemia can lead to anemia as it will disrupt the production of blood within the bone marrow. Neutropenia is a natural result of leukemia as the body’s supply of white blood cells is decreased. Thrombocytopenia is a reduced platelet count which can also result from leukemia, especially in infants.

    NURSE For Pete’s Sake

    N-Night Sweats

    U-Unexplained Weight Loss

    R-Risk for Infection

    S-Swollen Lymph Nodes

    E-Enlarged Liver or Spleen

    F-Fevers

    P-Persistent Fatigue

    S-Shortness of Breath

    Description

    Lymphoma usually presents with flu-like symptoms and swollen lymph nodes. This mnemonic will help you remember

    HOP to the hospital

    H-Hemodilution (IVF, PRBC’s)

    O-Oxygen Supplementation

    P-Pain Relief

    Description

    Treatment options for patients with Sickle Cell Anemia

    Pregnacies Are Very Interesting

    P-PROM

    A-Amniocentesis

    V-Vaginitis

    I-Intrauterine Procedure

    Description

    Common causes and risk factors for development of chorioamnionitis – infection and inflammation of the amniotic sac.

    KEEPS

    K-Klebsiella

    E-Ecoli

    E-Enterococcus

    P-Proteus mirabilis

    S-S. saphrophyticus

    Description

    Pathogens that are commonly associated with urinary tract infections

    FACTS

    F-Fever

    A-Aches

    C-Chills

    T-Tired

    S-Sudden onset

    Description

    Common symptoms of influenza

    HIPER

    H-Heat

    I-Indurations (hardening)

    P-Pain

    E-Edema

    R-Redness

    Description

    In response to tissue damage the body elicits the inflammatory response in attempt to rid itself of the initial offender. These attempts can sometimes become more of a problem than a solution.

    TORCH

    T-Toxoplasmosis

    O-Other (Group B Strep, HIV, Syphilis)

    R-Rubella

    C-Cytomegalovirus

    H-Herpes Simplex

    Description

    These are the possible types of infections that can affect both the mother and the fetus during pregnancy. They are Toxoplasmosis, other (GBS, HIV, Syphilis), Rubella, Cytomegalovirus and Herpes Simplex

    FICA

    F-Fetal exposure

    I-Immunosuppression

    C-Chickenpox as a child

    A-Aging

    Description

    These are common risk factors for reactivation of the varicella zoster virus into herpes zoster (shingles)

    TV SPARC CUBE

    T-Thirst

    V-Vomiting

    S-Sweating

    P-Pulse weak

    A-Anxious

    R-Respirations shallow/rapid

    C-Cool

    C-Cyanotic

    U-Unconscious

    B-BP low

    E-Eyes blank

    Description

    Mnemonic to help you remember the signs and symptoms of shock

    PIP

    P-Preicteric Stage

    I-Icteric Stage

    P-Posticteric Stage

    Description

    Assessment stages of hepatitis

    The 6 T’s

    T-Tachycardia

    T-Tachypnea

    T-Tremors

    T-Toxic look

    T-Tiredness

    T-Temperature (fever)

    Description

    Sepsis is a systemic response to inflammation as a result of uncontrolled infection. There is also a release of cytokines which lead to further inflammation and vascular dilation. Blood is shunted from the essential organs to non essential organs (the skin) leading to increased body temperature (along with response to infection). The heart begins to beat faster in response to the infection and to the decreased cardiac output as a result of the massive vasodilation.

    STEROID

    S-Sugar and sodium low

    T-Tired and muscle weakness

    E-Electrolyte imbalance of high Potassium and high Calcium

    R-Reproductive change

    O-lOw blood pressure

    I-Increased pigmentation of the skin

    D-Diarrhea and nausea, Depression

    Description

    Assessment findings of Addison’s Disease – caused by LOW secretion of adrenal hormones – glucocorticoids, mineralocorticoids, and androgens

    The 3 S’s

    S-Sugar (Glucocorticoids)

    S-Salt (Mineralcorticoids)

    S-Sex (Androgens)

    Description

    There are three different adrenal gland hormones which can be remembered as the 3 Ss: sugar (glucocorticoids) affects glucose utilization, fat metabolism and aid in reducing inflammation. Salt (mineralcorticoids) plays a role in electrolyte regulation. Androgens are commonly referred to as sex hormones.

    BRISH

    B-Bowel and bladder dysfunction

    R-Risk of respiratory failure

    I-Increased pulse, respirations, and BP

    S-Sudden severe motor weakness

    H-Hypoxia and cyanosis

    Description

    Assessment findings for a myasthenic crisis nurs 623 mnemonics

    STRESSED

    S-Skin fragile

    T-Truncal obesity with small arms

    R-Rounded face

    E-Ecchymosis, Elevated blood pressure

    S-Striae on the extremities and abdomen (Purplish)

    S-Sugar extremely high

    E-Excessive body hair especially in women, Electrolytes imbalance: hypokalemia

    D-Dorsocervical fat pad (Buffalo hump), Depression

    Description

    Assessment findings of Cushing’s Disease – caused by EXCESS secretion of adrenal hormones – glucocorticoids, mineralocorticoids, and androgens. One of these, Cortisol, is also called the Stress hormone (STRESSED).

    DDD

    D-Diabetes insipidus

    D-Deficient ADH (Central DI) or ADH Doesn’t work (Nephrogenic DI)

    D-Dilute urine (< 300 mosm/L) Description Pathophysiology of Diabetes Insipidus The 3 Ps P-Polyuria (excessive urination) P-Polydypsia (excessive thirst) P-Polyphagia (excessive hunger) Description In type 1 diabetes mellitus a patient does not produce insulin. Insulin allows glucose to go from the blood into the cells for energy. When glucose does not get into the cell, glucose levels in the blood rise. The body tries to remove excess glucose by producing extra urine. The body then requires more water.We get hungry because our cells are starving for energy. SOAP BRAIN MD S-Serositis O-Oral ulcers A-Arthritis P-Photosensitivity B-Blood disorders R-Renal involvement A-Antinuclear antibodies I-Immunologic phenomena (eg, dsDNA; anti-Smith [Sm] antibodies) N-Neurologic disorder M-Malar rash D-Discoid rash Description Diagnostic criteria for Systemic Lupus Erythematosus KING UFC K-K+ (Potassium) I-Inuslin N-Nasogastric tube G-Glucose (once serum level drops) U-Urea monitoring F-Fluids C-Creatinine monitoring Description Common treatment for diabetic ketoacidosis DEMYELINATION D-Diploplia E-Eye movement painful M-Motor: weakness and spasticity Y-nYstagmus E-Elevated temperature L-Lhermitte’s phenomenon N-Neuropathic pain A-Ataxia T-Talking slurred I-Impotence O-Overactive bladder N-Numbness Description Common symptoms associatied with multiple sclerosis, a disease that causes demyelination in the central nervous system CREST C-Calcinosis R-Raynaud’s E-Esophageal dysmotility S-Sclerodactyly T-Telangiectasia Description Calcinosis-deposits of calcium in the connective tissue. Raynaud’s- hands and feet are often cold from lack of circulation. Esophageal dysmotility-patient has a hard time swallowing from a tightened esophagus. Sclerodactyly- tight thick skin on the fingers. Telangiectasia-visible swollen small blood vessels like spider veins SWEATING S-Sweating W-Weight loss E-Emotional lability A-Appetite increased T-Tremor/Tachycardia I-Intolerance of heat N-Nervousness G-GI problems Description Symptoms of hypethyroidism MOM’S SO TIRED M-Memory loss O-Obesity M-Malar flush/Menorrhagia S-Slowness (mentally and physically) S-Skin and hair dryness O-Onset gradual T-Tiredness I-Intolerance to cold R-Raised BP E-Energy levels fall D-Depression/Delayed relaxation of reflexes Description Symptoms of hypothyroidism MALE M-Male or Mid 30s and up A-Alcohol drinker L-Loves high purine diet and lifestyle is sedendary E-Excessive weight Description Common risk factors for Gout or a Gout attack RHEUMATOID R-Respiratory distress (Interstitial lung disease, bronchiolitis, pleural effusion) H-Haematological manifestations (anemias, thrombocytosis, neutropenia) E-Extra- articular RA (ExRA) U-Urinary tract infections (mainly drug- induced) M-Median nerve compression/ Morning stiffness A-Amyloidosis T-Tenosynovitis and bursitis O-Ocular manifestations (Keratoconjunctivitis sicca, scleritis, episcleritis) I-Immunologic manifestations (Sjogren’s, Felty’s and Caplan’s syndrome) D-Deformities (boutonniere, swan- neck, button- hole) Description Common findings of rheumatoid arthritis ACCESS A-Alcohol use C-Corticosteroids C-Calcium use E-Estrogen low S-Smoking S-Sedentary lifestyle Description Common risk factors for osteoporosis OSTEO O-Outgrowths of Bone (Nodes) S-Stiff Joints T-Tender Joints E-Experience Crepitus with Movement O-Only Joints, NOT systemic Description Differentiating Osteoarthritis RICE R-Rest I-Ice C-Compression E-Elevation Description These four basic interventions can help to alleviate the symptoms of a sprain or a strain. A strain is excessive stretching of muscle. A sprain is excessive stretching of ligament. TRACTION T-Temperature (Extremity, Infection) R-Ropes hang freely A-Alignment C-Circulation Check (5 Ps) T-Type & Location of fracture I-Increase fluid intake O-Overhead trapeze N-No weights on bed or floor Description Nursing care and responsibilities with patients in traction. nurs 623 mnemonics. AEIOU TIPS A-Alcohol/durgs E-Endocrine I-Insulin O-Overdose U-Uremia T-Trauma I-Infection P-Psychiatric S-Shock Description There are many reasons why a patient may present with altered mental status. Neurological injury is not the only reason for AMS! Make sure you explore all possibilities. GBS = PAID G-Growing weakness B-Breathing problems S-Sensory disturbances P-Protien present in CSF A-Autonomic neuropathy I-Infection D-Dymyelinating nerve studies Description There are common assessment findings that are important for a nurse to understand when caring for a patient with Guillain-Barre Syndrome The 5 A’s A-Amnesia – loss of memories A-Anomia – unable to recall names of everyday objects A-Apraxia – unable to perform tasks of movement A-Agnosia – inability to process sensory information A-Aphasia – disruption with ability to communicate Description The 5 A’s of Alzhemiers Disease. These signs point to a diagnosis of Alzheimer’s Type Dementia SMART S-Shuffling gait M-Mask like face A-Akinesia R-Rigidity T-Tremors Description Common assessment findings and signs of Parkinson’s Disease ABCDEFG A-Autonomic Regulation B-Breathing Problems C-Clots D-Discomfort E-Elimination Problems F-Functional Ability G-Grief nurs 623 mnemonics Description Patient with spinal cord injury may experience multiple long-term complications due to the loss of nerve function in various parts of their body. Olympic Opium Occupies Troubled Triathletes After Finishing Vegas Gambling Vacations Still High O-Olfactory O-Optic O-Oculomotor T-Trochlear T-Trigeminal A-Abducens F-Facial V-Vestibulocochlear G-Glossopharyngeal V-Vagus S-Spinal Accessory H-Hypoglossal Description This is one mnemonic that can help you remember the order of the twelve cranial nerves. Remember the Spinal Accessory nerve (CN XI) can also be called the “Accessory” Oh Oh Oh To Touch And Feel Very Good Velvet AH! O-Olfactory O-Optic O-Oculomotor T-Trochlear T-Trigeminal A-Abducens F-Facial V-Vestibulocochlear G-Glossopharyngeal V-Vagus A-Accessory H-Hypoglossal Description This is one mnemonic that can help you remember the order of the twelve cranial nerves. Remember the Spinal Accessory nerve (CN XI) can also be called the “Accessory” On Old Obando Tower Top A Filipino Army Guards Villages And Huts O-Olfactory O-Optic O-Oculomotor T-Trochlear T-Trigeminal A-Abducens F-Facial V-Vestibulocochlear G-Glossopharyngeal V-Vagus A-Accessory H-Hypoglossal Description This is one mnemonic that can help you remember the order of the twelve cranial nerves. Remember the Spinal Accessory nerve (CN XI) can also be called the “Accessory” Craniums Excite Me C-Craniotomy E-External ventricular drain Medications (mannitol, steriods) nurs 623 mnemonics Description Three interventions that can reduce ICP are craniotomies, external ventricular drains, and medications HAS H-Headache A-Altered mental status S-Seizures Description There are three global symptoms for brain tumors. If you see these, plus localized symptoms, it’s possible the patient HAS a brain tumor. HATS H-Hypertension A-Anticoagulant therapy T-Trauma S-Substance abuse (coacaine) Description Common risk factors associated with hemorrhagic stroke Pretty Little Liars Forever P-Phenytoin L-Lacosamide L-Levetiracetam F-Fospheytoin Description Common medications proven to be effective in preventing seizure activity FAN LIPS F-Fever A-Altered level of consciousness N-Nuchal rigidity L-Lethargy I-Increased intracranial pressure P-Photophobia S-Seizures Description Meningitis causes several systemic and specifically, neurological symtoms VITAMIN V-Vascular I-Infections T-Trauma A-AV Malformation M-Metabolic I-Idiopathic N-Neoplasms Description Common causes that can produce seizures in patients COAT C-Confusion O-Opthalmoplegia A-Ataxia T-Thiamine deficiency Description Four cardinal symptoms that are present in patient’s with Wernicke’s Encephalopathy SAME S-Sensory A-Afferent M-Motor E-Efferent Description The peripheral nervous system is divided into two main pathways – Sensory, or Afferent, and Motor, or Efferent DEMENTIA DEMENTIA Make certain they don’t have problems with: D-Drugs and alcohol E-Eyes and ears M-Metabolic and endocrine disorders E-Emotional disorders N-Neurologic disorders T-Tumors and trauma I-Infection A-Arteriovascular disease Description When assessing a patient for dementia it is important to ensure that one of the following listed conditions isn’t an underlying cause for the dementia symptoms. SIGNS S-Sleep Disturbances I-Interest Decreased G-Guilty Feelings N-No Energy S-Sadness (Crying spells) Description Monitor for these SIGNS in patients that may be at risk for depression HEADSS H-Home & Environment E – Education & Employment A-Activities D-Drugs S-Sexuality S-Suicide & Depression Description Guidance for a psychosocial interview to determine high risk behavior in adolescents DIG FAST D-Distractibility I-Indiscretion G-Grandiosity F-Flight of Ideas A-Activity Increase S-Sleep Deficit T-Talkative Description The above signs would be indicative of a patient experiencing a manic episode. A manic episode is a state in which the patient experiences abnormally elevated mood, typically lasting at least one week. Think of a dog ‘manically’ digging for a bone. JAMCO J-Judgment A-Affect M-Memory C-Cognition O-Orientation Description These 5 things should be assessed in a patient with senile dementia. Judgment – can a patient determine the outcome of a choice or assess risk? Affect – ability to express feeling or emotion. Memory – assess short and long term memory. Cognition- ability to process and relate information. Orientation – assess if a patient is oriented to person, place, time. Having Extremely Frustrating Labor H-Hypotonic/Hypertonic Contractions E-Extremely Large Fetus F-Fetal Position L-Less than Ideal Pelvic Structure Description These are possible causes of labor dystocia – difficult labor. Hypotonic or Hypertonic Contractions can make the force ineffective or uncoordinated. Extremely large fetus – a large baby can get stuck in the birth canal. Fetal position being awkward or abnormal can cause a fetus to get stuck – i.e. breech or shoulder presentation. And Less than ideal pelvic structure – it could be shaped funny due to a spinal defect or just be too small 4 T’s T-Tone T-Trauma T-Tissue T-Thrombin Description Tone: uterine atony is the inability of the uterus to contract and may lead to continuous bleeding (most common). Trauma: Injury to the birth canal during delivery. Tissue: retention of tissue from the placenta or fetus. Thrombin: Bleeding disorders (coagulopathies) – the most dangerous being DIC CHILD ABUSE C-Child’s excessive knowledge of sex and abusive words H-Hair growth in various lengths I-Inconsistent stories from the child and parent/s L-Low self-esteem D-Depression A-Apathy, no emotion B-Bruised U-Unusual injuries S-Serious injuries E-Evidence of old injuries Description Child abuse can be in many forms; physical, sexual, emotional, or neglect. Any act of commission or omission by a caregiver that harms or may cause harm to a child is child abuse. As a healthcare professional it is important to be in-tune with the preceding warning signs or indicators of child abuse. CLEFT LIP C-Choking L-Lie on back E-Evaluate Airway F-Feed Slowly T-Teaching L-Larger nipple opening I-Increased incidence in males P-Prevent crust formation and aspiration Description Cleft lip is a congenital slit in the skin above the lip, typically also associated with a cleft palate. The typical treatment is reconstructive surgery. Post op care includes monitoring for choking. Baby should lie on their back during sleep to prevent trauma to sutures. Make sure to evaluate the airway and ensure it is open and monitor for aspiration. Feed the baby slowly in an upright position with a larger nipple opening. Prevent crust formation. Lastly, provide teaching to parents regarding feeding and common care.  nurs 623 mnemonics. The 4 T’s T-Tetralogy of Fallot T-Truncus Arteriosus T-Transposition of the Great Vessels T-Tricuspid Atresia Description Cyanotic heart defects are a group of congenital heart defects that result from deoxygenated blood by-passing the lungs and going into systemic circulation. Tetralogy of Fallot includes 4 anatomical abnormalities that are pictured below. Truncus Arteriosus is a condition where the pulmonary trunk and aorta don’t properly divide in development. This results in one large vessel carrying mixed blood to the heart, lungs, and systemic circulation. Transportation of the Great Vessels is a condition where vessels are swapped or may be in abnormal positions. Tricuspid Atresia is a condition where there is no tricuspid valve, which leads to an undersized or absent right ventricle. REEDA R-Redness E-Edema E-Ecchymosis D-Discharge, Drainage A-Approximation Description Redness with pain, excess edema, ecchymosis (bruising), or discharge/drainage from the wound can all be signs of problems with healing after an episiotomy. Wound edges should be well approximated. Topical ointments and ice packs may be indicated if there is pain or excess swelling, or other signs of infection. RIBCAGE R-Radiation I-Immune reaction B-Bugs (infection) C-Cervical incompetemce A-Anatomical anamoly G-Genetic E-Endocrine Description Common causes that can place a pregnancy at risk for miscarriage and other problems VEAL CHOP V-Variable E-Early A-Accelerations L-Late C-Cord Compression H-Head Compression O-Okay P-Placental Insufficiency Description A fetal acceleration is an abrupt increase in fetal heart rate above the established baseline. A fetal deceleration is a decrease in fetal heart rate below the established fetal heart rate. VEAL CHOP can be used to help remember how to interpret fetal heart rate during labor. For example, early decelerations in FHR (fetal heart rate) indicate head compression. It is typical for decels in FHR during a contraction because of head compression, but FHR should return to normal when contraction ends. Stop MOAN S-STOP infusion M-Mom turned on side O-O2 administration A-Assess baby and mom to see if changes occurred N-Notify Provider Description These interventions should be implemented if a fetus is in distress during induction of labor with uterine stimulants. First things first, STOP the infusion, Mom should be turned to her side, give supplemental O2, Assess mom and baby, and notify the provider ALONE A-Amniocentesis L-L/S Ratio O-Oxytocin Test N-Non-Stress Test E-Estriol Level Description An amniocentesis is performed during the prenatal period. A needle is inserted to obtain a sample of amniotic fluid, which can be used to identify chromosomal abnormalities. L/S ratio compares lecithin– phosphatidyl choline to sphingomyelin to identify infant lung maturity. The oxytocin test measures fetal heart rate during contractions induced by oxytocin. A non-stress test measures fetal heart rate while baby is at rest and while baby is moving. Estriol levels in mother’s blood can be a marker for fetal well-being. HELLP H-Hemolysis E-Elevated L-Liver function tests L-Low P-Platelet count Description HELLP syndrome is a severe and life-threatening complication, typically related to preeclampsia. It typically occurs in the third trimester.The defining characteristics are hemolysis (breakdown of red blood cells), elevated liver enzymes, and low platelet count. FINES F-Feeding difficulty I-Inspiratory Stridor N-Nares Flares E-Expiratory Grunting S-Sternal Retractions Description The above signs are indications that the patient is attempting to draw in more oxygen. The patient will begin to compensate for the decreased tissue oxygenation by exhibiting the following signs and symptoms. PAINS P-Period (menstrual: late, spotting, bleeding) A-Abdominal pain, dyspareunia (painful intercourse) I-Infection (abnormal vaginal discharge) N-Not feeling well, fever or chills S-String missing Description An intrauterine device is inserted into the uterus and is used to prevent pregnancy. There are two different types: hormonal and copper IUD. NNN N-Non-reactive N-Non-Stress test is N-Not good Description A non-reactive result in a non-stress test is not good. During a non-stress test the fetal heart rate is monitored during movement. A reactive result is a good sign indicating intact central and autonomic nervous system. A reactive non-stress test result would be 2 accelerations to a certain level for greater than 15 seconds within a 20 minute period. If this does not occur the test is non-reactive. ACHES A-Abdominal Pain C-Chest Pain H-Headache E-Eye Problems S-Severe Leg Pain Description Because oral contraceptives can cause clots, we should monitor for the following serious complications in patients taking oral contraceptives: abdominal pain, chest pain, headache, eye problems, swelling or aching in the legs or thighs. BUBBLE B-Breasts U-Uterus B-Bowels B-Bladder L-Lochia E-Episiotomy-laceration/C-section – incision Description Make sure to assess the following in patients postpartum: 1. Breasts – engorgement 2. Uterus -check for bogginess (firming up and dropping to original location) 3. Bowel- flatus, bowel movement, frequency 4. Bladder – note frequency and amount of urination. Patient may have a catheter, check for anything unusual like blood or sediment in urine. 5. Lochia – normal post-partum vaginal discharge, note color and amount 6. Episiotomy-laceration/C-section-incision – check for any signs that wound is not properly healing. (See acronym REEDA to assess episiotomy) nurs 623 mnemonics GTPAL G-Gravidity T-Term Births P-Preterm Births A-Abortions/Miscarriages L-Living Children Description These are the things to consider when determining pregnancy outcomes. How many pregnancies has the mother had? How many of those came to full term (>37 weeks)? How many preterm births (20-37 weeks)? How many abortions or miscarriages before 20 weeks? How many living children? Note that twins count together until the Living category.

    CHOP BUGS

    C-Chadwicks – bluish discoloration of lower uterine segment

    H-Hegar – softening of lower uterine segment

    O-Outlining of Fetal Body

    P-Positive pregnancy test – presence of gonadotropin in urine

    B-Ballotement – sinking and rebound of fetus

    U-Uterine Enlargement – at 12 weeks gestation felt just above symphsis pubis

    G-Goodells – Softening of the cervix

    S-Souffle, Contraction and Braxton Hicks (painless contraction at 28 weeks)

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    Description

    Probable and positive signs and symptoms of pregnancy. These signs indicate a likely pregnancy. Positive signs involve the presence of a heartbeat on ultrasound.

    ALPPPS

    A-Attitude

    L-Lie

    P-Presentation

    P-Presenting part

    P-Position

    S-Station

    Description

    ALPPPS will help you to remember the aspects to assess in respect to the baby during the process of labor. Attitude is the head position, Lie explains which directiont the baby is lying. Presentation is the way the baby is facing. Presentation part is which part of the baby is coming out of the mom (i.e. head, feet). Position is based on which way the baby is facing. Station is how far down the birth canal the baby is.

    4 P’s

    P-Powers

    P-Passageway

    P-Passenger

    P-Psyche

    Description

    The 4 P’s describe the mother’s role in the process of labor. The 4P’s all work together and essential to facilitate a safe and successful delivery. Powers – The power the mother exerts to push out the baby – Uterine power (contractions) and Cervical power (dilation and effacement). Passageway – the pathway the baby takes out of the mother’s body (pelvis and related structures). Passenger – the baby and placenta. Psyche – Mom’s emotional state: Supportive, therapeutic environment will facilitate a smoother labor. Fearful, angry, tense emotions will make labor much more difficult

    Proficiently Expanding Fetus

    P-Preembryonic

    E-Embryonic

    F-Fetal

    Description

    As the fetus “expands” or grows, it passes through three stages – the Preembryonic stage up to week 2, the Embryonic stages from weeks 2 – 8, and the Fetal stage from week 8 to birth.

    2A 1V

    2A-Two Areolas, Two Arteries

    1V-One Vagina, One Vein

    Description

    To remember the vasculature in the umbilical cord, remember that the mom has: Two areolas; One Vagina. So, there are Two umbilical arteries, one umbilical vein.

    4 Can’ts

    CAN’T-See – blurred vision

    CAN’T-Pee – urinary retention

    CAN’T-Spit – dry mouth

    CAN’T-S*** – constipation

    Description

    “Anti” means NOT – so these are all the things they CAN’T do because of Anticholinergics (Side Effects)

    Donuts And TLC

    D-Diazepam

    A-Alprazolam

    T-Temazepam

    L-Lorazepam

    C-Clonazepam

    Description

    When you feel anxious, you need Donuts And TLC. These are the most common Benzodiazepines

    1 Heart, 2 Lungs

    BETA 1-One Heart

    BETA 2-Two Lungs

    Description

    Beta 1 adrenergic receptors are mostly found in the heart. Beta 2 adrenergic receptors are found in lungs, GI tract, vascular smooth muscle, skeletal muscle, liver. Beta 1 beta blockers act primarily on the heart. Beta 2 beta blockers act primarily on the lungs.

    SLUDGE

    S-Salivation

    L-Lacrimation

    U-Urination

    D-Defecation

    G-Gastric upset

    E-Emesis

    Description

    A cholinergic crisis can occur if the body stops properly breaking down Acetylcholine. This can cause overactivity of Acetylcholine at the neuromuscular junction. Acetylcholine is part of Rest & Digest (Parasympathetic) – so we see overactive digestion and secretion.

    These Drugs Can Interact

    T-Theophylline

    D-Dilantin

    C-Coumadin

    I-llosone (Erythromycin)

    Description

    Coumadin and ilosone: Ilosone can increase the effects of Coumadin, increase risk for bleeding. Coumadin and Dilantin: potential for increased effects of both. Coumadin and Dilantin: Increased Coumadin metabolism (decreased effect). Theophylline and Dilantin: if taken orally they can interfere with absorption of each other and decrease medication effect.

    I C NASA

    I-Ibuprofen

    C-Carbamazepine

    N-Naproxen Sodium

    A-Allopurinol

    S-Sulfa Antibiotics

    A-Acetaminophen

    Description

    “I see NASA” – think “Johnson Space Center”. These are the most common drugs that can cause Stevens Johnson Syndrome. Most often Sulfa Antibiotics

    IDEA

    I-Isoproterenol

    D-Dopamine

    E-Epinephrine

    A-Atropine

    S-Sulfate

    Description

    This refers to symptomatic bradycardia and hypotension. Bradycardia and hypotension are not necessarily adverse clinical findings requiring treatment in and of themselves.

    LEAN

    L-Lidocaine

    E-Epinephrine

    A-Atropine Sulfate

    N-Narcan

    Description

    The above drugs work in a variety of emergency settings, they are good drugs to LEAN on. Lidocaine can be used in emergency situations for ventricular arrhythmias. Epinephrine is a vital drug in the ACLS protocol. Atropine can be given with symptomatic bradycardia. Narcan is a reversal agent for opiate overdose.

    PAINS

    P-Period (menstrual: late, spotting, bleeding)

    A-Abdominal pain, dyspareunia (painful intercourse)

    I-Infection (abnormal vaginal discharge)

    N-Not feeling well, fever or chills

    S-String missing

    Description

    An intrauterine device is inserted into the uterus and is used to prevent pregnancy. There are two different types: hormonal and copper IUD.

    SAMS

    S-Slurred Speech

    A-Altered Central Nervous System

    M-Muscle Twitching

    S-Seizures

    Description

    Lidocaine is an anesthetic that prevents painful impulses from reaching the brain. These are signs that the patient may have had too much lidocaine (like buying in bulk)

    TIPS

    T-Tranylcypromine

    I-Isocarboxazid

    P-Phenelzine

    S-Selegiline

    Description

    These are the most common MAO Inhibitors. Note: Selegiline is a selective MAO-B inhibitor and comes in a transdermal patch. The others are non-selective and oral medications.

    Sometimes I Can’t Answer

    S-Salicylates

    I-Immunomodulators

    C-Corticosteriods

    A-Antidiarrheals

    Description

    Classess of medicatios that are commonly used for inflammatory bowel disease

    Please Make Tummy Better

    P-Proton pump inhibitor

    M-Mentronidazole

    T-Tetracycline

    B-Bismuth

    Description

    Medications used in the treatment of pancreatitis

    ADME

    A-Absorption

    D-Distribution

    M-Metabolism

    E-Excretion

    Description

    “Add Me” – These are the 4 steps/components of pharmacokinetics, or how the body processes a drug. Absorption is getting the drug into the systemic circulation, Distribution is getting the drug to the target organs, Metabolism (performed by the Cytochrome P450 system) is making the drug active and excretable, and Excretion is the process of getting the drug (or its metabolites) out of the system.

    Effective For Sadness, Panic, & Compulsions

    E-Escitalopram

    F-Fluoxetine

    S-Sertraline

    P-Paroxetine

    C-Citalopram

    Description

    SSRI’s are antidepressant medications. These are the most common.

    6 S’s

    S-Sugar – hyperglycemia

    S-Soggy Bones – causes osteoporosis

    S-Sick – decreased immunity

    S-Sad – depression

    S-Salt – water and salt retention (hypertension)

    S-Sex – decreased libido

    Description

    Steroids are an effective treatment for asthma, COPD, Crohn’s, Lupus and more. However,they have the potential for very serious side effects, which are indicated by the 6 S’s. Steroids can be taken by mouth, via an inhaler, topically, or via injection. nurs 623 mnemonics

    RIPE

    R-Rifampin

    I-Isoniazid

    P-Pyrazinamide

    E-Ethambutol

    Description

    Drugs used to treat tuberculosis

    FUN WISE

    F-Frequency

    U-Urgency

    N-Nocturia

    W-Weak stream

    I-Intermittency

    S-Straining

    E-Emptying incompletely

    Description

    Common symptoms of Benign Prostatic Hyperplasia (BPH) involve difficulty with a normal urine stream and difficulty emptying the bladder

    Patients Complain of Pain and Difficulty Urinating

    P-Protein intake

    C-Calcium intake

    P-Purine intake

    D-Dehydration

    U-Urinary stasis

    Description

    Increased concentration of calcium, proteins, or uric acid crystals can cause renal calculi to form. These are some of the possible causes.

    TONIC

    T-Tubular necrosis

    O-Obstruction

    N-Nephrotoxic medications

    I-Infection

    C-Contrast dye

    Description

    Common intrarenal causes of acute kidney injury

    Please Help Deliver Diuretics

    P-Plasmapheresis

    H-Hemodialysis

    D-Dietary changes

    D-Diuretics

    Description

    Therapy for glomerulonephritis. This would include diuretics to improve clearance of toxins from the kidneys

    FUN

    F-Frequency

    U-Urgency

    N-Nocturia

    Description

    As a patient begins to develop prostate enlargement they will start to demonstrate urinary symptoms including those listed below.

    NAPHROTIC

    N-Na+ decreased (dilutional)

    A-Albumin decrease

    P-Proteinuria

    H-Hyperlipidemia

    R-Renal Vein Thrombosis

    O-Orbital Edema

    T-Thromboembolism

    I-Infection

    C-Coagulability

    Description

    Common symptoms of Nephrotic Syndrome

    P-DIAPERS

    P-Psychologic

    D-Delirium

    I-Infection

    A-Atrophic Urethra

    P-Pharmaceuticals – blood pressure medication, antidepressants, diuretics, sleeping pills

    E-Excess Urine Output

    R-Restricted Mobility

    S-Stool Impaction

    Description

    These are common causes of transient incontinence – when a patient cannot hold their urine and becomes incontinent without warning, periodically. This occurs in children and commonly in older adults

    AEIOU

    A-Acid-Base Problems

    E-Electrolyte Problems

    I-Intoxications

    O-Overload of fluids

    U-Uremic Symptoms

    Description

    As a patient progresses from chronic kidney disease to end stage renal disease the need for dialysis becomes more imminent. When the kidneys are no longer able to filter the blood alone you will see problematic metabolic acidosis since they kidneys can’t excrete excess acids that are in the blood. During kidney failure, excess potassium isn’t excreted and levels will start to rise. The kidneys help remove certain medications from the body, and when they aren’t working, toxicity can occur even with normal doses. Patients with ESRD become fluid overloaded due to inadequate urine production. Uremia will occur as the body can’t excrete enough urea.

    MTV

    M-Measles

    T-Tuberculosis

    V-Varicella

    Description

    Diseases that should have airborne precautions. “MTV is on the air.”

    GUT PASS

    G-Gastric aspiration

    U-Uremia

    T-Trauma

    P-Pancreatitis (acute)

    A-Amniotic fluid embolism

    S-Sepsis

    S-Shock

    Description

    Common causes of Acute respiratory distress syndrome

    ASTHMA

    A-Adrenergic (albuterol)

    S-Steroids

    T-Theophylline

    H-Hydration (IV)

    M-Mask (oxygen)

    A-Antibiotics

    Description

    The therapeutic management for a patient with asthma. Asthma is a spasming of the airways, which causes difficulty breathing.

    Many Boys Love Food

    M-Medications

    B-Beestings

    L-Latex

    F-Food

    Description

    Common causes of anaphlactic reactions

    The 6 P’s

    P-Pulmonary Bronchial Constriction

    P-Possible Foreign Body

    P-Pulmonary Embolus (PE)

    P-Pneumothorax

    P-Pump Failure

    P-Pneumonia

    P-Pneumothorax

    Description

    These are six major causes for dyspnea. Pulmonary bronchial constriction prevents the passage of air into the lungs which contributes to dyspnea. (Possible) foreign bodies can become trapped or logged within the trachea restricting air flow. Pulmonary embolisms can prevent complete oxygenation of the blood in the alveoli due to restricted blood flow. Pneumothorax collapses the lung and prevents full expansion, restricting oxygenation. Pump failure refers to the heart not beating appropriately. If the heart is not perfusing the lungs than the lungs will be unable to oxygenate the blood. Pneumonia leads to poor lung ventilation as well.

    All People Can Value Lungs

    A-Atelectasis

    P-Pulmonary edema

    C-Clot

    V-Vasoconstriction

    L-Low blood volume

    Description

    Common causes associated with poor gas exchange in the body

    TWO AA’S

    T-Tidaling

    W-Water seal

    O-Output

    A-Air leak

    A-Ability to breathe

    S-SpO2

    Description

    Chest tube assessments that should be completed and documented by the nurse to ensure safety for the patient

    Patients Sometimes Bleed Internally

    P-Pneumothorax

    S-Subcutaneous Emphysema

    B-Bleeding

    I-Infection

    Description

    Possible complications that can occur from a thoracentesis

    COPD

    C-Cigarette smoking cessation, corticoseteriods

    O-Oxygen if hypoxic

    P-PFTs + Pneumococcal vaccine, (flu vaccine if not given for that year) + Pulmonary Rehabilitation

    D-Dilators

    Description

    The therapeutic management for a patient with COPD

    RAT BED

    Early Hypoxia:

    R-Restlessness

    A-Anxiety

    T-Tachycardia / Tachypnea

    Late Hypoxia:

    B-Bradycardia

    E-Extreme Restlessness

    D-Dyspnea

    Description

    Patients experiencing hypoxia will initially demonstrate signs of anxiety and restlessness. As hypoxia continues, the patients conditions deteriorates to bradycardia and dyspnea.

    FINES

    F-Feeding difficulty

    I-Inspiratory Stridor

    N-Nares Flares

    E-Expiratory Grunting

    S-Sternal Retractions

    Description

    The above signs are indications that the patient is attempting to draw in more oxygen. The patient will begin to compensate for the decreased tissue oxygenation by exhibiting the following signs and symptoms.

    VENTS

    V-View ABGs, airway status

    E-Elevated HOB to 30 degress

    N-Note GI complications (stress ulcers)

    T-Take notice of ventilator settings and alarms

    S-Suction tracheal tube

    Description

    Ventilator Associated Pneumonia prevention bundle

    P-THORAX

    P-Pleuritic pain

    T-Trachea deviation

    H-Hyper resonance

    O-Onset sudden

    R-Reduced breath sounds

    A-Absent fremitus

    X-X-ray shows collapse

    Description

    Signs and symptoms commonly associated with a pneumothorax

    MAD DOG

    M-Morphine

    A-Aminophylline

    D-Digitalis

    D-Diuretics

    O-Oxygen

    G-Gases

    Description

    The therapeutic managment for a patient with pulmonary edema

    Please Assess His Weird Bronchoscopy Results

    P-Persistant cough

    A-Abnormal CXR

    H-Hemoptysis

    W-Washout suputum

    B-Biopsy

    R-Remove obstruction

    Description

    Indications for a bronchoscopy include either diagnostics or treatment reasons

    Don’t Ever Fail

    D-Drain fluid, blood, or air

    E-Establish negative pressure

    F-Facilitate lung expansion

    Description

    Reasons for chest tube insertion

    PAINT

    P-Pleural

    A-Alveolar

    I-Interstitial

    N-Neuromuscular

    T-Thoracic

    Description

    Categories of common causes of restrictive lung disease causes

  • PUB-550: Application and Interpretation of Public Health Data

    PUB-550: Application and Interpretation of Public Health Data

    Topic 1: Data Management and Descriptive Statistics

    Objectives:

    Evaluate methods of data organization.

    Compare characteristics of correlational, experimental, and quasi-experimental (observational) statistics variables.

    Identify the four levels of measurement.

    Differentiate between a population and a sample, and a parameter and a statistic (descriptive and inferential).

    Explain the role of quantitative and qualitative methods and sciences in describing and assessing a population’s health. PUB-550: Application and Interpretation of Public Health Data

    Evaluate public health data sources.

    Apply methods to calculate and communicate descriptive statistics.

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    Data Management

    The purpose of this
    assignment
    is to practice organizing data through ordering and grouping variables.

    Data often appear disordered and it is difficult to see any connections or relationships. Ordering the data by certain variables or grouping variables into specific categories, such as age or sex categories, can help bring clarity to the data. Knowing how to organize data is an important skill to initiate the analytical process.

    For this assignment, students will use Excel and SPSS Statistics to order variables. Using the “Example Dataset,” complete the steps below using both Excel and SPSS Statistics. View the Excel and SPSS tutorials for assistance in completing this assignment. Submit one Word document and include a screen shot of the data after completing the first two steps of Part 1 in Excel and SPSS to compare your results. Use a second Word document to complete Part 2 of the assignment. PUB-550: Application and Interpretation of Public Health Data

    Part 1: Ordering and Grouping Data Using Excel and SPSS

    For Part 1, accomplish the following:

    Order (sort) observations according to age.

    Group observations by sex and investigate the age and income for males and females.

    Create a new variable titled “Exercise Group” based on the variable “Minutes Exercise.” Use the following categories to create your groups: 1 = 0-30 minutes; 2 = 31-60 minutes; 3 = 61-90 minutes; 4 = 91-120 minutes; and 5 = 120+ minutes.

    Part 2: Data Interpretation

    Study the results of the dataset grouping and ordering. Discuss the following in a 500-750 word summary:

    Describe the measurement levels for each of the variables in the dataset.

    Discuss what you learned from ordering the data by age and why this information is important.

    Describe the process you used to group the data in Excel and SPSS.

    Describe what you learned by grouping the variables by category of exercise.

    Are these data from a correlational study, experimental study, or quasi-experimental (observational) study? Discuss your rationale and identify a study question appropriate for this dataset. PUB-550: Application and Interpretation of Public Health Data

    General Requirements

    Submit the Word document to the instructor.

    APA style is not required, but solid academic writing is expected.

    This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

    You are required to submit this assignment to LopesWrite. Refer to the
    LopesWrite Technical Support articles
    for assistance.

    Attachments

    PUB-550-RS-Example Dataset.xlsx

    Rubric

    Due Date:

    05-Mar-2020 at

    A local community organization was interested in learning about general health behaviors in the area and the relationships between health behaviors and environmental and social determinants. They decided to conduct a brief survey based on a convenient sample of people visiting the local shopping mall. They offered a $5 incentive for completing the survey. The Topic 1 Example dataset includes 30 observations from this survey. Use this data to complete the relevant assignments in this course.

    Education Level

    1

    Less than High School

    2

    Graduated High School

    3

    Graduated College

    Annual Income = US Dollars

     

    ID

    Sex

    Smoker

    Education_Level***

    Minutes_Exercise

    Age

    Employed

    Annual_Income*

    Neighborhood

    101

    Female

    No

    2

    90

    45

    Yes

    51000

    B

    102

    Male

    No

    2

    50

    58

    No

    23000

    C

    103

    Female

    Yes

    3

    65

    31

    Yes

    35000

    B

    104

    Male

    No

    1

    20

    54

    No

    10000

    C

    105

    Female

    Yes

    1

    50

    30

    Yes

    28000

    B

    106

    Female

    Yes

    2

    25

    18

    No

    5000

    C

    107

    Female

    No

    3

    110

    39

    Yes

    46000

    A

    108

    Male

    Yes

    1

    50

    37

    Yes

    36000

    B

    109

    Female

    Yes

    2

    40

    44

    Yes

    51000

    C

    110

    Male

    No

    2

    80

    24

    No

    12000

    A

    111

    Female

    No

    3

    120

    42

    Yes

    78000

    A

    112

    Male

    No

    1

    80

    50

    Yes

    34000

    D

    113

    Female

    Yes

    1

    60

    20

    No

    15000

    B

    114

    Male

    No

    3

    150

    35

    Yes

    28000

    B

    115

    Male

    No

    2

    75

    61

    Yes

    28000

    A

    116

    Male

    No

    1

    80

    59

    No

    24000

    B

    117

    Female

    No

    2

    110

    36

    Yes

    55000

    D

    118

    Male

    Yes

    3

    80

    35

    Yes

    62000

    B

    119

    Male

    Yes

    2

    100

    29

    No

    32000

    D

    120

    Female

    No

    1

    0

    32

    No

    7000

    C

    121

    Female

    Yes

    2

    50

    26

    No

    17000

    B

    122

    Female

    No

    3

    200

    42

    Yes

    64000

    D

    123

    Male

    No

    2

    60

    52

    No

    5000

    A

    124

    Male

    No

    1

    65

    49

    No

    14000

    D

    125

    Female

    No

    1

    40

    21

    No

    20000

    C

    126

    Male

    Yes

    3

    65

    48

    Yes

    72000

    A

    127

    Female

    Yes

    3

    70

    40

    Yes

    85000

    A

    128

    Female

    No

    1

    45

    53

    No

    15000

    B

    129

    Male

    No

    3

    75

    46

    Yes

    64000

    C

    130

    Male

    Yes

    3

    50

    42

    Yes

    27000

    B

     

    Topic 1 DQ 1

    Mixed methods research is becoming an important approach in generating public health evidence. Based on the resources supplied, discuss the benefits of a mixed methods approach. Include an explanation of the differences between qualitative and quantitative research and the purpose of each.

    Topic 1 DQ 1

    Mixed methods research has become increasing popular, however the definition of mixed methods research has yet to be agreed upon (Ozawa & Pongpirul, 2014). Essentially, mixed methods research studies incorporate quantitative and qualitative data to utilize the strengths of both types of research methods (Ozawa & Pongpirul, 2014). In health systems, mixed methods research is critical because it allows researchers to see issues from various perspectives, contextualize information, have a better understanding of the issue, form results, quantify difficult measures, create illustrations for trends, and examine processes (Ozawa & Pongpirul, 2014).To make sense of the assembly of mixed method research designs, there are four categories; the triangulation design, the embedded design, the explanatory design, and the exploratory design (Almalki, 2016). The triangulation design is practical because this type of research gathers data from different sources and utilizes different methods, which all work together as well-organized design (Almalki, 2016). With the embedded design, less resources are needed, and it produces less data, making it easier for researchers to grasp (Almalki, 2016). The explanatory design is easy to implement, and it enables the focus of the research to be maintained (Almalki, 2016). With the exploratory design, separate stages are easy to apply, also qualitative information is acceptable to quantitative researchers (Almalki, 2016).Quantitative research regards the world as being outside of themselves. The purpose is to gain an understanding about the social world (Almalki, 2016). The qualitative approach gains a perspective of issues by investigating them in their own specific setting. The purpose is to observe occurrences and bring meaning to them (Almalki, 2016). The differences between quantitative and qualitative research is as follows:

    Quantitative Approach

    Qualitative Approach

    Deductive

    Inductive, with underlying assumptions reality is a social construct

    Subdivides reality into smaller, manageable pieces

    Places emphasis on exploring and understanding

    Observations are made and hypotheses can be tested among variables

    Variables are difficult to measure

    Primacy of subject matter

    Conclusions are made with regard to the hypothesis, following a series of observations and analysis of data

    Data collected will consist of an insider’s viewpoint

    (Almalki, 2016).

    References

    Almalki, S. (2016). Integrating Quantitative and Qualitative Data in Mixed Methods Research – Challenges and Benefits.
    Journal of Education and Learning.
    doi:10.5539/jel.v5n3p288. Retrieved from https://files.eric.ed.gov/fulltext/EJ1110464.pdf

    Ozawa, S. & Pongpirul, K. (2014). 10 best resources on…mixed methods research in health systems.
    Health Policy and Planning.
    Retrieved from https://academic.oup.com/heapol/article/29/3/323/581455

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    Re: Topic 1 DQ 1

    The delivery of healthcare is becoming more complex as evidence by the rising number of individuals with comorbidities and the shift towards the quality of care versus quantity. Addressing challenges that are generated by this complex system requires research that not only produces statistical data, but also understands a population’s natural setting and provides insight how he research can be applied to that setting. Mixed methods research is becoming an important approach in generating public health evidence because it combines both qualitative and quantitative research. Qualitative research answers clinical question regarding meaning and quality improvement and provides descriptive data while quantitative research answers clinical question regarding therapy, etiology, diagnosis, prevention, and prognosis and produces numerical data (Winona State University, 2014). Favorable characteristics of mixed method research include consistency between the research question, purpose and methodological choices; verifiable and transparent techniques that demonstrate trustworthiness; potential for replicability; opportunity for self-correction; and ability to explain the phenomena under investigation (Newman and Hitchcock, 2012). Furthermore, benefits to mixed methods include answering questions that qualitative or quantitative research cannot answer alone; provides better understanding of connections or contradictions between qualitative and quantitative data; it gives participants an opportunity to have a voice and share the experience across the research process [which is important within public health]; it facilitates different avenues of exploration that enhance the quality of evidence and enables questions to be answered more deeply (Shorten & Smith, 2017). A mixed method approach uses the combine strengths of qualitative and quantitative data. Its unique design is appropirate to addressing complex public health issues.Hitchcock, J. H., & Newman, I. (2012). Applying an Interactive Quantitative-Qualitative Framework.
    Human Resource Development Review
    ,
    12
    (1), 36–52. https://doi.org/10.1177/1534484312462127Shorten, A., & Smith, J. (2017). Mixed methods research: expanding the evidence base.
    Evidence Based Nursing
    ,
    20
    (3), 74–75. https://doi.org/10.1136/eb-2017-102699Winona State University. (2014). Research Hub: Evidence Based Practice Toolkit: Levels of Evidence. Retrieved from Winona.edu website: https://libguides.winona.edu/c.php?g=11614&p=61584

     

    1 DQ 2

    Topic One, Discussion Question 2:Statistics are ways to summarize data in a way that will answer a specific question (Corty, 2016). There are several key words that help with defining statistics, such as population, sample, parameter and statistic.During investigation studies researchers look for subjects to study. These subjects from large groups called a population (Corty, 2016). If the research only wanted to look at a small group of this population, they would call that a sample (Corty, 2016).For example – If I were to do a research study on obesity, I could use the state of Kentucky as my population. However, if I wanted to only look at Shelbyville, Kentucky that would be a sample of Kentucky.Data from either the sample or the population which can be reduced to a simple number like an average to summarize the group (Corty, 2016). If it is characterizing the sample, it is called a statistic; if it is characterizing the population it is called a parameter. Sample statistics use Latin letters as their symbol and population parameters use Greek letters (Corty, 2016).Then there is descriptive and inferential statistics. Descriptive is the summary statement about the set of cases (Corty, 2016). It reduces a set of data to a meaningful value to describe the characteristics of the group being observed – for example: 63% of the class were females. Inferential statistics uses a sample of cases to draw a conclusion about the larger population and reduces the data down to a single value that inferences about the population (generalization from the sample to a population – for example: Students who are female at GCU have a 15% higher GPA on average than males (Corty, 2016).Public health researchers often limit or rather stop their analyses to descriptive statistics—reporting frequencies, means and standard deviation (Guetterman, 2019). This allows for missed opportunities for more advanced analyses. “For example, knowing that patients have favorable attitudes about a treatment may be important and can be addressed with descriptive statistics. On the other hand, finding that attitudes are different (or not) between men and women and that difference is statistically significant may give even more actionable information to healthcare professionals” (Guetterman, 2019). This missing piece about differences can be addressed through inferential statistical tests (Guetterman, 2019). Therefore, both are extremely important to public health research.

    References:

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    Corty, E. (2016). Using and interpreting statistics. A practical text for the behavioral, social, and health sciences 3
    rd
    Edition. Retrieved from
    https://viewer.gcu.edu/GGdEcj

    Guetterman, T., (2019). Basics of statistics for primary care research.
    Family Medicine Community Health. 7
    (2). Retrieved from:
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6583801/

     

    Practicing Application of Descriptive Statistics in Excel and SPSS

    The purpose of this assignment is to compare basic functions in
    Excel and SPSS to calculate descriptive statistics
    and use this information to describe the sample.

    For this assignment, students will utilize Excel with the Data Analysis ToolPak and SPSS Statistics and the “Example Dataset” to complete the assignment. Refer to the Topic Materials for assistance with enabling the Data Analysis ToolPak on a Mac or PC.

    Part 1:

    Complete the following steps in both Excel and IBM SPSS Statistics.

    Calculate mean, median, and mode for the variables “Annual Income” and “Age.” Show the appropriate summary tables for these measures from both Excel and SPSS. Include the other descriptive statistics that are a part of the summary output in Excel and SPSS.

    Create histograms to show the distribution for “Annual Income” and “Age.” Copy and paste the histograms from Excel and export the histogram from SPSS into the Word document for this assignment.

    Create frequency tables that include counts and percentages for smoking status, employment status, exercise level, and education level. Show the tables in the Word document for this assignment.

    Part 2:

    Based upon the Part 1 activities, write a 250-500 word interpretation that addresses the following.

    Discuss the sampling strategy used in this study and if it resulted in a representative sample.

    Discuss what you are able to ascertain about the sample from the descriptive statistics.

    Explain what other variables the research team could have included to gain a better understanding of the population.

    General Requirements

    Submit one Word document for the Part 1 assignment content and a second Word document for Part 2 of the assignment.

    APA style is not required, but solid academic writing is expected.

    This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

    You are not required to submit this assignment to LopesWrite.

    Attachments

    PUB-550-RS-Example Dataset.xlsx

     

    Calculating Confidence Intervals

    The purpose of this
    assignment
    is to practice
    calculating confidence intervals
    .

    For this assignment, students will utilize Excel and SPSS Statistics and the “Example Dataset.”

    Using the “Example Dataset,” complete the following:

    Based on a normal distribution curve, calculate the probability of an individual being 60 years or older in this population. Show the Excel and SPSS formulas or your hand calculations. Include screenshots as needed to illustrate this.

    Using the sample standard deviation of age as an estimate of the population standard deviation, calculate by hand the standard error of the mean. Show your calculations and the answer.

    Calculate by hand a 95% confidence interval for “Age” based on the sample mean. Use SPSS to verify your answer. Include your calculations and screenshots of the SPSS output.

    Interpret the confidence interval for age and explain the three pieces of information needed to calculate a confidence interval.

    Submit one Word document that includes all of the assignment deliverables.

    APA style is not required, but solid academic writing is expected.

    This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

    You are not required to submit this assignment to LopesWrite.

    Attachments

    PUB-550-RS-Example Dataset.xlsx

     

    Topic 2 DQ 1

    P-values and confidence intervals are both used in hypothesis testing. Explain three reasons why it may be preferable to report a confidence interval over a P-value. Provide a specific example to justify your reasons.

    Topic 2 DQ 1

    De Prel et al. (2009) study found the following: P-values in scientific studies are used to determine whether a null hypothesis formulated before the performance of the study is to be accepted or rejected. In exploratory studies, p-values enable the recognition of any statistically noteworthy findings. Confidence intervals provide information about a range in which the true value lies with a certain degree of probability, as well as about the direction and strength of the demonstrated effect. This enables conclusions to be drawn about the statistical plausibility and clinical relevance of the study findings. It is often useful for both statistical measures to be reported in scientific articles, because they provide complementary types of information (p.335).

     

    According to de Prel et al. (2009) “For example, there might be no difference between two antihypertensives with respect to their ability to reduce blood pressure. The alternative hypothesis (H
    1
    ) then states that there is a difference between the two treatments. This can either be formulated as a two-tailed hypothesis (any difference) or as a one-tailed hypothesis (positive or negative effect). In this case, the expression “one-tailed” means that the direction of the expected effect is laid down when the alternative hypothesis is formulated (p.335).

     

    Reference

    du Prel, J. B., Hommel, G., Röhrig, B., & Blettner, M. (2009). Confidence interval or p-value?: part 4 of a series on evaluation of scientific publications.
    Deutsches Arzteblatt international
    ,
    106
    (19), 335–339. doi:10.3238/arztebl.2009.0335

     

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    Topic 2 DQ 2

    The Central Limit Theorem is the fundamental theorem of statistics. In a nutshell, it says that for independent and identically distributed data whose variance is finite, the sampling distribution of any mean becomes more nearly normal (i.e., Gaussian) as the sample size grows (Chang, Wu, Ho and Chen, 2008). The sample mean ¯xn will then approach the population mean µ, in distribution. More formally, where N (0, 1) is the normal distribution and the symbol “d” in the equality means in distribution. σn is the standard deviation of a sampling distribution, σ is the standard deviation of the entire population the study (and which is often not known), and n the sample size. So, sample means vary less than individual measurements. (The square of the standard deviation is the variance.). The sampling distribution is a notional (imaginary) distribution from a very large number of samples, each one of size n, which approaches a normal distribution in the limit of large n. In practice, the Central Limit Theorem holds for n as low as 30, unless there are exceptional circumstances—e.g., when the population distribution is highly skewed—in which case higher values are needed. So, σn measures how widely the sample means of size n vary around the population mean µ (which is approached in the limit of large n). As expected, the results suggest that the distribution of the sample mean better approximates the normal distribution as the sample size increases. The results indicate that the true distribution of the sample mean when the sample is taken from a highly skewed distribution better approximates the normal distribution as the thickness of the tail of the population distribution increases.

    Chang, H. J., Wu, C. H., Ho, J. F., & Chen, P. (2008). On sample size in using central limit theorem for gamma distribution

     

    Topic 3: Hypothesis Testing

    Objectives:

    Evaluate the importance of hypothesis testing in statistics and public health research.

     

    Hypothesis Testing

    The purpose of this assignment is to evaluate the steps of hypothesis testing.

    Hypothesis testing
    is a central component in understanding and interpreting public health research. Research questions are applied through a testable hypothesis established before the data is collected. It provides the rationale for the study and guides the researcher in what tests to use and how to interpret the results.

    Identify a peer-reviewed article from one of the data sources available on the “Data Resource Document.” You will need to visit the various websites listed on the document to search for a research article that is of interest to you. Include the link to the selected article in a 750-1,000 word summary that address the following as it relates to the article.

    What test statistic did the researchers use? What did the authors set as the significance level of the test statistic?

    What was the null hypothesis? What was the alternative hypothesis? Were these clearly stated in the article, or did you have to extrapolate based on the background in the article?

    Discuss potential bias that may have resulted from the study design and data collection that could have affected the validity of the test.

    Summarize the story told by the data used in this study as it applies to the larger population

    Comment on whether the authors used the interpretation approach discussed in the textbook, including (a) summarize why the study was done, (b) discuss the factual results, (c) explain what the results mean, and (d) make suggestions for future research.

    Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

    This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

    You are required to submit this assignment to LopesWrite. Refer to the
    LopesWrite Technical Support articles
    for assistance.

    Attachments

    PUB-550-RS-Data Resource Document.docx

     

    Topic 3 DQ 1

    Discuss the four potential outcomes of hypothesis testing and describe what is meant by type 1 and type 2 errors. Provide an example of when these errors might occur.

    Topic 3 DQ 1

    Banerjee et al., (2009) study found the following: Hypothesis testing is an important activity of empirical research and evidence-based medicine. A well worked up hypothesis is half the answer to the research question. For this, both knowledge of the subject derived from extensive review of the literature and working knowledge of basic statistical concepts are desirable. The present paper discusses the methods of working up a good hypothesis and statistical concepts of hypothesis testing (p.127)

    Banerjee et al., (2009) study found the following: Just like a judge’s conclusion, an investigator’s conclusion may be wrong. Sometimes, by chance alone, a sample is not representative of the population. Thus, the results in the sample do not reflect reality in the population, and the random error leads to an erroneous inference. A type I error (false-positive) occurs if an investigator rejects a null hypothesis that is actually true in the population; a type II error (false-negative) occurs if the investigator fails to reject a null hypothesis that is actually false in the population. Although type I and type II errors can never be avoided entirely, the investigator can reduce their likelihood by increasing the sample size (the larger the sample, the lesser is the likelihood that it will differ substantially from the population) (p.127).

    Banerjee et al., (2009) study found the following: False-positive and false-negative results can also occur because of bias (observer, instrument, recall, etc.). (Errors due to bias, however, are not referred to as type I and type II errors.) Such errors are troublesome, since they may be difficult to detect and cannot usually be quantified (p.127).

     

     

    Reference

    Banerjee, A., Chitnis, U. B., Jadhav, S. L., Bhawalkar, J. S., & Chaudhury, S. (2009). Hypothesis testing, type I and type II errors.
    Industrial psychiatry journal
    ,
    18
    (2), 127–131. doi:10.4103/0972-6748.62274

     

    Topic 3 DQ 1

    The four potential outcome of hypothesis testing are

    Correct inference: Conclude that there is an association when one does exist in the population.

    Correct inference:Conclude that there is no association when one does not exist in the population.

    Incorrect inference (type 1): Conclude that there is an association when there actually is none (false positive).

    Incorrect inference (type 2): Conclude that there is no association when there is one (false negative) (Banerjee, Chitnis, Jadhav, Bhawalkar, & Chaudhruy, 2009)

     

    When the sample is not representative of the population this leads to an erroneous inference and type 1 or type 2 errors. A type 1 error is a false positive, or an investigator rejecting a null hypothesis that is actually true (Banerjee, Chitnis, Jadhav, Bhawalkar, & Chaudhruy, 2009). A type 2 error is the opposite a false negative, an investigator rejecting a null hypothesis that is actually false in the population. These errors are impossible to completely avoid but the likelihood can be decreased by increasing the sample size and (Banerjee, Chitnis, Jadhav, Bhawalkar, & Chaudhruy, 2009).

     

    Bibliography

    Banerjee, A., Chitnis, U., Jadhav, S., Bhawalkar, J., & Chaudhruy, S. (2009). Hypothesis Testing, type 1 and type II errors.
    Indian Psychiatry
    , 127-131.

     

    Topic 3 DQ 2

    Review the Healthy People 2020 website. Identify one of the health issues and propose a scenario that would use a z-test as the first step in the six steps of hypothesis testing. Discuss the remaining five steps based on your scenario, including clearly articulating the null and alternative hypotheses for your scenario.

     

    Topic 3 DQ 2

    Sphweb (n.d) study found the following: The Centers for Disease Control (CDC) reported on trends in weight, height and body mass index from the 1960’s through 2002.
    1
    The general trend was that Americans were much heavier and slightly taller in 2002 as compared to 1960; both men and women gained approximately 24 pounds, on average, between 1960 and 2002. In 2002, the mean weight for men was reported at 191 pounds. Suppose that an investigator hypothesizes that weights are even higher in 2006 (i.e., that the trend continued over the subsequent 4 years). The
    research hypothesis
    is that the mean weight in men in 2006 is more than 191 pounds. The
    null hypothesis
    is that there is no change in weight, and therefore the mean weight is still 191 pounds in 2006(n.d).

    Sphweb (n.d) study found the following: In order to test the hypotheses, we select a random sample of American males in 2006 and measure their weights. Suppose we have resources available to recruit n=100 men into our sample. We weigh each participant and compute summary statistics on the sample data. Suppose in the sample we determine the following:

    n=100

    s=25.6

    Sphweb (n. d). study found the following: Do the sample data support the null or research hypothesis? The sample mean of 197.1 is numerically higher than 191. However, is this difference more than would be expected by chance? In hypothesis testing, we assume that the null hypothesis holds until proven otherwise. We therefore need to determine the likelihood of observing a sample mean of 197.1 or higher when the true population mean is 191 (i.e., if the null hypothesis is true or under the null hypothesis). We can compute this probability using the Central Limit Theorem. Specifically, (n.d.).

    Review of the “Nutrition and Weight Status” on the Healthy People 2020

    Obesity in Adults (NWS-9)

    Healthy People 2020 objective NWS-9 tracks the proportion of adults with obesity (BMI ≥ 30).

    HP2020 Baseline: In 2005–2008, the rate of obesity was 33.9% among adults aged 20 years and over (age adjusted).

    HP2020 Target: 30.5%, a 10% improvement over the baseline.

    Most Recent: In 2013–2016, the rate of obesity was 38.6% among adults aged 20 years and over (age adjusted).

    Males aged 20 years and over had a lower rate of obesity than females (36.5% versus 40.5%, age adjusted) in 2013–2016. The rate for females was 11.0% higher than that for males.

    Among racial and ethnic groups, the non-Hispanic Asian population had the lowest (best) rate of obesity, 12.5% of adults aged 20 years and over (age adjusted) in 2013–2016. Rates (age adjusted) for other racial and ethnic groups were:

    0% among the non-Hispanic black population; more than 3.5 times the best group rate

    9% among the Hispanic population; more than 3.5 times the best group rate

    1% among the non-Hispanic white population; 3 times the best group rate

     

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    Reference

    Explore the Healthy People 2020 website.

    URL:

    https://www.healthypeople.gov/

     

     

    Null and Alternative Hypothesis

    http://sphweb.bumc.bu.edu/otlt/MPH-Modules/BS/BS704_HypothesisTest-Means-Proportions/BS704_HypothesisTest-Means-Proportions_print.html

     

    Topic 4: The t-Test

    Objectives:

    Differentiate the use of three types of t-tests.

    Explain the assumptions of the t-test.

    Interpret t-test results to determine the difference in means.

     

    Application of the t-Test

    The purpose of this assignment is to learn how to apply the t-test to a sample dataset.

    For this assignment, students will use IBM SPSS Statistics and the “Example Dataset.”

    Using the “Example Dataset” and SPSS, apply the t-test to assess the following statement: “Men and women have different incomes in this city.”

    Show your calculations and copy of the SPSS output in a Word document.

    In a separate 250-500 Word document, address the following questions:

    Describe what
    t-test
    is the most appropriate and explain why. Discuss whether you used a one-tailed or two-tailed test and explain why.

    Using SPSS, calculate the t-test and provide the test statistic and critical value assuming an alpha of .05.

    Calculate the effect size using
    r
    2
    .

    Interpret the results by (a) stating the reason the study or test was done, (b) presenting the main results, (c) explaining what the results mean, and (d) making suggestions for future research.

    Submit both Word documents to the instructor. PUB-550: Application and Interpretation of Public Health Data

    APA style is not required, but solid academic writing is expected.

    This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

    You are not required to submit this assignment to LopesWrite.

    Attachments

    PUB-550-RS-Example Dataset.xlsx

     

    Topic 4 DQ 1

    Compare the three types of t-tests by discussing when each is most appropriate to use and which types of questions each type of t-test best answers. Include specific examples to illustrate the appropriate use of each test.

    Topic 4 DQ 1

    In statistics, t-tests are a type of hypothesis test that allows you to compare means. They are called t-tests because each t-test boils your sample data down to one number, the t-value. If you understand how t-tests calculate t-values, you’re well on your way to understanding how these tests work.

    In this series of posts, I’m focusing on concepts rather than equations to show how t-tests work. However, this post includes two simple equations that I’ll work through using the analogy of a signal-to-noise ratio (Editor, M.B.,2019, n.d.).

    Both the signal and noise values are in the units of your data. If your signal is 6 and the noise is 2, your t-value is 3. This t-value indicates that the difference is 3 times the size of the standard error. However, if there is a difference of the same size but your data have more variability (6), your t-value is only 1. The signal is at the same scale as the noise (Editor, M.B.,2019, n.d.).

    In this manner, t-values allow you to see how distinguishable your signal is from the noise. Relatively large signals and low levels of noise produce larger t-values. If the signal does not stand out from the noise, it’s likely that the observed difference between the sample estimate and the null hypothesis value is due to random error in the sample rather than a true difference at the population level (Editor, M.B.,2019, n.d.). PUB-550: Application and Interpretation of Public Health Data

    Many people are confused about when to use a paired t-test and how it works. I’ll let you in on a little secret. The paired t-test and the 1-sample t-test are actually the same test in disguise! As we saw above, a 1-sample t-test compares one sample mean to a null hypothesis value. A paired t-test simply calculates the difference between paired observations (e.g., before and after) and then performs a 1-sample t-test on the differences (Editor, M.B.,2019, n.d.).

    Understanding that the paired t-test simply performs a 1-sample t-test on the paired differences can really help you understand how the paired t-test works and when to use it. You just need to figure out whether it makes sense to calculate the difference between each pair of observations (Editor, M.B.,2019, n.d.).

    Reference

    Editor, M. B. (n.d.). Understanding t-Tests: 1-sample, 2-sample, and Paired t-Tests. Retrieved September 27, 2019, from
    https://blog.minitab.com/blog/adventures-in-statistics-2/understanding-t-tests-1-sample-2-sample-and-paired-t-tests
    .

     

    Topic 4 DQ 2

    Step 2 of hypothesis testing involves reviewing the assumptions of the test you selected. Discuss the three assumptions of the t-test. Provide an example of the assumption that is not robust to violations and a situation when the assumption is violated. PUB-550: Application and Interpretation of Public Health Data

    Topic 4 DQ 2

    Hoekstra (2012) study found the following:Using a statistical test is one of the frequently mentioned methods of checking for violations of assumptions (for an overview of statistical methodology textbooks that directly or indirectly advocate this method, see e.g., Hayes and Cai,
    2007
    ). However, it has also been argued that it is not appropriate to check assumptions by means of tests (such as Levene’s test) carried out before deciding on which statistical analysis technique to use because such tests compound the probability of making a Type I error (e.g., Schucany and Ng,
    2006
    ). Even if one desires to check whether or not an assumption is met, two problems stand in the way. First, assumptions are usually about the population, and in a sample the population is by definition not known. For example, it is usually not possible to determine the exact variance of the population in a sample-based study, and therefore it is also impossible to determine that two population variances are equal, as is required for the assumption of equal variances (also referred to as the assumption of homogeneity of variances) to be satisfied. Second, because assumptions are usually defined in a very strict way (e.g., all groups have equal variances in the population, or the variable is normally distributed in the population), the assumptions cannot reasonably be expected to be satisfied(p.1)Hoekstra (2012) study found the following:The assumptions of normality and of homogeneity of variances are required to be met for the
    t-
    test for independent group means, one of the most widely used statistical tests (Hayes and Cai,
    2007
    ), as well as for the frequently used techniques ANOVA and regression (Kashy et al.,
    2009
    ). The assumption of normality is that the scores in the population in case of a
    t-
    test or ANOVA, and the population residuals in case of regression, be normally distributed. The assumption of homogeneity of variance requires equal population variances per group in case of a
    t-
    test or ANOVA, and equal population variances for every value of the independent variable for regression. Although researchers might be tempted to think that most statistical procedures are relatively robust against most violations, several studies have shown that this is often not the case, and that in the case of one-way ANOVA, unequal group sizes can have a negative impact on the technique’s robustness (e.g., Havlicek and Peterson,
    1977
    ; Wilcox,
    1987
    ; Lix et al.,
    1996
    )(p.2)ReferenceHoekstra, R., Kiers, H. A., & Johnson, A. (2012). Are assumptions of well-known statistical techniques checked, and why (not)?.
    Frontiers in psychology
    ,
    3
    , 137. doi:10.3389/fpsyg.2012.00137

     

    Topic 5: ANOVA Testing

    Objectives:

    Compare and contrast the types of ANOVA tests and their application.

    Apply the results of an ANOVA to determine statistical difference between means and potential interactions.

    PUB-550: Application and Interpretation of Public Health Data

     

    Application of ANOVA

    The purpose of this assignment is to calculate and interpret an ANOVA table. For this assignment, use IBM SPSS Statistics.

    Part 1:

    Using the “Example Dataset,” assess this statement using ANOVA: “People with different levels of education exercise for different amounts of time during the week.”

    Select and conduct the appropriate ANOVA test to assess the statement. Export the ANOVA table to a Word document.

    Part 2:

    In 250-500 words, discuss the following regarding the use of ANOVA.

    Describe when the use of ANOVA is more appropriate than the use of a t-test.

    Describe which ANOVA test you used and why.

    Interpret the results by (a) stating the reason the study or test was done; (b) presenting the main results, including explaining the within and between subjects variation and the F-ratio from the ANOVA table; (c) explaining what the results mean, including discussing whether there is a statistically significant difference between education groups and amount of exercise; and (d) making suggestions for future research. PUB-550: Application and Interpretation of Public Health Data

    General Requirements

    Submit one Word document for the Part 1 assignment content and a second Word document for Part 2 of the assignment. Submit both Word documents to the instructor.

    APA style is not required, but solid academic writing is expected.

    This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

    You are not required to submit this assignment to LopesWrite.

    Attachments

    PUB-550-RS-Example Dataset.xlsx

     

    Topic 5 DQ 1

    Compare the various types of ANOVA by discussing when each is most appropriate for use and which types of research questions each best answers. Include specific examples to illustrate the appropriate use of each test and how interaction is assessed using ANOVA.

    Topic 5 DQ 1

    Analysis of variance (ANOVA) is a unit of statistical tests used to compare the means of two or more groups (Corty, 2016). There are two types of tests: between subjects, one-way ANOVA and between subjects, two-way ANOVA. ‘Between subjects’ means independent samples and ‘way’ means explanatory view. ‘Way’ can be grouping variables or independent variables (Corty, 2016) PUB-550: Application and Interpretation of Public Health Data.

    The one-way ANOVA is a statistical test used when comparing the means of two or more independent samples when there is only one explanatory variable (Corty, 2016). A one-way ANOVA is most appropriate when used to assess the differences in one continuous variable between one grouping variable (Statistics Solutions, 2020). One- way ANOVA allows more groups to be compared at once, allowing more complex questions to be addressed (Corty, 2016). For example, a one-way ANOVA would be appropriate if the goal of research is to assess for differences in job satisfaction levels between ethnicities (Statistics Solutions, 2020). This type of example would require a question regarding one dependent variable, job satisfaction, and one independent variable, ethnicity.

    The two-way ANOVA allows researchers to examine the impact of two explanatory variables at one time (Corty, 2016). The two-way ANOVA is most appropriate to use when there are two or more influencing factors at one time. A two-way ANOVA answer the most complex questions involving multiple influencing factors (Corty, 2016). For example, a researcher performed a study on factors that influence altruism and has interest in both how the children are reared and what their nervous systems are like, nurture vs. nature (Corty, 2016). The study was preformed using adoptive children. Below is the design stud with multiple levels of altruism as the influencing factors:

     

    Adoptive Parents

    High on Altruism

    Adoptive Parents

    Medium on Altruism

    Adoptive Parents

    Low on Altruism

    Birth Parents

    High Altruism

    Birth Parents

    Low Altruism

    (Corty, 2016)

    References

    Corty, E.W. (2016).
    Using and Interpreting Statistics: A Practical Text for the Behavioral, Social, and Health Sciences. (3
    rd
    Ed.)
    New York, NY: Worth Publishers

    Statistics Solutions. (2020). The Various Forms of ANOVA. Retrieved from https://www.statisticssolutions.com/the-various-forms-of-anova/ PUB-550: Application and Interpretation of Public Health Data

     

    Topic 5 DQ 2

    Different types of software can be used for data management. Compare Excel and SPSS and discuss specific SPSS software features that make it preferable to Excel for data management. Provide examples illustrating when electing to use SPSS could be preferable to Excel and vice versa.

    5 DQ 2

    When it comes to statistical analysis there are a few different types of software that can be used for data management. There are two types used in the PUB 550 course at Grand Canyon University. The first is Excel, which is a spreadsheet software that can also be used for statistical analysis. The other is SPSS, Statistical Package for Social Sciences, is an actual statistical analysis software (Statistics Solutions, 2019). Excel is an easy to use software that allows researchers to format data into a table format or spreadsheets, with rows and columns, and then filter the data using formulas (Mittermeier, 2019). The primary purpose of Excel is to create records of data along with manipulation of the data into visual analysis in preparation for formal presentations and reports. SPSS is specifically made for statistical analysis. The software has been used by researchers for decades to perform quantitative analysis of data, allowing for import of statistical packages from other databases and spreadsheets (Statistics Solutions, 2019). Excel utilizes formulas to perform analyses, that the user is expected to be knowledgeable of, whereas SPSS has specific tools to recode and transform variables without additional knowledge of the user required. SPSS is specific to the social sciences as it allows for comparative studies and statistical techniques at a large scale, although limited as it is unable to perform analyses for large data sets from the medical field for clinical data (Statistics Solutions, 2019). PUB-550: Application and Interpretation of Public Health Data. Although both software are capable of aiding researchers in performing statistical analysis on data they have collected, one is significantly more useful in the type of analysis researchers in public health and other social sciences need. SPSS is designed for data analysis in the social sciences and overall is the most user friendly and forgiving, as errors of accidental overwrites or sorting can be avoided unlike Excel worksheets (Mittermeier, 2019).

    References

    Mittermeier, E. (2019). Why you should move from Excel to SPSS. Retrieved from
    https://www.2×4.de/2019/06/11/why-you-should-move-from-excel-to-spss/

    Statistics Solutions. (2019). SPSS statistics help. Retrieved from
    https://www.statisticssolutions.com/spss-statistics-help/

     

    Topic 6: Regression

    Objectives:

    Apply the steps of a
    regression analysis
    to determine the linear regression equation and its appropriateness based on the data.

    Interpret regression output to predict changes in a dependent variable based on changes in one or more predictor variables.

    Application of the Pearson Correlation Coefficient and the Chi-Square Test

    The purpose of this assignment is to practice calculating and interpreting the Pearson correlation coefficient and a chi-square test of independence.

    For this
    assignment
    , complete Problems 13.132 and 15.88 in the textbook. Include your process for conducting the calculations. You can complete the calculations by hand or using Excel or SPSS. If you use Excel or SPSS, copy and paste your output results into a Word document.

    When addressing each textbook problem, provide a response for each of the six steps of hypothesis testing listed below.

    Pick a test.

    Check the assumptions.

    List the hypotheses.

    Set the decision rule.

    Calculate the test statistic.

    Interpret the results. (What was done? What was found? What does it mean? What suggestions exist for future research?) PUB-550: Application and Interpretation of Public Health Data

    Submit a Word document with your problem answers to each of the six steps. If Excel or SPSS was used to complete the assignment, submit the second Word document containing the screenshots to the instructor.

    This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

    You are not required to submit this assignment to LopesWrite.

    Topic 7 DQ 1

    Correlation is a common statistic to measure a general linear relationship between two variables. Explain why correlation does not equal causation. Describe the data characteristics necessary to calculate a Pearson correlation coefficient. Design a study that would apply the Pearson correlation coefficient as an appropriate statistic.

    BUY A PLAGIARISM-FREE PAPER HERE

    Topic 7 DQ 1

    Correlation between two variables proves only that there is an association it doesn’t guarantee that one causes the other (Corty, 2016). If two variables vary together systematically a cause and effect relationship may exist but there does not have to be, it is possible there is a third variable (Corty, 2016). When an association is demonstrated further research is needed to assess the strength of the relationship this is where the Pearson test comes in. The Pearson test calculates a correlation coefficient that summarizes the strength of the linear relationship between two variables, a strong relationship would suggest causation (Corty, 2016).

    Data necessary to calculate a Pearson correlation coefficient must be interval and/or ratio, for an ordinal variable the Spearman rank order test can be used and for two nominal variables the chi-square test can be used (Corty, 2016).

    A study that would be appropriate for the Pearson correlation coefficient would be a study of the need for prescription glasses and its relationship to age.

     

    References

     

    Corty, E. (2016).
    Using and interpreting statistics
     
    : a practical text for the behavioral, social, and health sciences
    . New York: Worth Publishers.

    Topic 7 DQ 2

    Describe the conditions in which a nonparametric test would be a better selection than a parametric test. Illustrate your ideas with a specific example of when you would use each type of test using similar variables for each example.

    Topic 7 DQ 2

    Parametric tests should only be used when assumptions about the parameters are met (Corty, 2016). Nonparametric tests do not have to meet these same assumptions. There are two circumstances in which a nonparametric test should be used: PUB-550: Application and Interpretation of Public Health Data

    The outcome variable is ordinal or nominal (Corty, 2016).

    During an experiment, if a nonrobust assumption is violated, the researcher can revert back to a nonparametric test from a parametric test (Corty, 2016).

    Nonparametric tests are less restricted by assumptions and relatively simple to conduct, making them desirable. Although, they are often not as influential on the null hypothesis as parametric test (Corty, 2016). The reason nonparametric tests have less power is that they only contain nominal or ordinal data rather than interval/ratio data. Nominal and ordinal numbers contain less information, thus giving nonparametric tests less power (Corty, 2016). Generally, researchers prefer parametric tests, but when the assumptions are not met, nonparametric tests are used.

    When the outcome is an ordinal variable or a rank, it is appropriate to use a nonparametric test. For example, a clinical trial is performed where study participants are asked to rate illness symptoms on severity for six weeks for a specific, assigned treatment. Symptom severity is measured on a 5-point ordinal scale with the following response options:

    Symptoms got much worse

    Symptoms are slightly worse

    No change

    Slightly improved

    Much improved

    (Sullivan, 2016).

    Outcomes that are ordinal, ranked, subject to outliers or measured imprecisely are difficult to analyze with parametric tests without making major assumptions (Sullivan, 2016). An appropriate and most effective test for the example above is the nonparametric test.

    Parametric tests can also be used for ordinal variables as long as the ordinal variables are continuous. For example, an experiment analyzing the weight and height of firefighters could use a parametric test because the ordinal variables are continuous.

    References

    Corty, E.W. (2016).
    Using and Interpreting Statistics: A Practical Text for the Behavioral, Social, and Health Sciences. (3
    rd
    Ed.)
    New York, NY: Worth Publishers

    Sullivan, L. (2016). Nonparametric Tests. Retrieved from http://sphweb.bumc.bu.edu/otlt/MPH-Modules/BS/BS704_Nonparametric/BS704_Nonparametric_print.html PUB-550: Application and Interpretation of Public Health Data

     

    Topic 8: Analyzing and Reporting Results

    Objectives:

    Apply hypothesis testing steps to a data set.

    Communicate scientific information for public health practice.

    Select quantitative and qualitative data collection methods appropriate for a given public health context.

    Analyze quantitative and qualitative data using biostatistics, informatics, computer-based programming, and software, as appropriate.

    Interpret results of data analysis for public health research, policy, or practice.

     

     

    Benchmark – Analyzing and Reporting Data

    The purpose of this
    assignmen
    t is analyze a dataset and report findings to relevant stakeholders.

    Read the Topic Material “Analyzing and Reporting Data – Overview” prior to beginning the assignment.

    For this assignment, you will use IBM SPSS Statistics and one of the three datasets to conduct a basic statistical analysis and report the results by creating a scientific poster. MPH students can use this assignment as an introduction to the option of a larger secondary data analysis for their capstone project.

    Select a public health topic that is of interest to you and complete the following using the “GCU MPH Poster Template.”

    Review the three datasets provided in the Topic Materials and brainstorm at least one potential research question that could be answered by one of the datasets. The question should be based on a topic that is of interest to you and is supported by existing literature.

    Select the dataset and organize the data to complete the analysis.

    Provide descriptive statistics that summarize the sample.

    Select an appropriate statistical test and conduct the analysis.

    Interpret the results of your analysis.

    Prepare your poster presentation putting the results in the context of the larger story surrounding the purpose for the analysis. Consider the data source, assumptions, hypotheses, decision rule, and interpretation.

    In addition to the poster, write a 1,000-word summary of the analysis that addresses the questions below. The summary should include additional discussion notes you would include for each section if you were presenting your poster at a professional conference. Typically, a poster presentation involves presenting your poster to small groups and providing an oral explanation as the audience reviews your poster. PUB-550: Application and Interpretation of Public Health Data

    Summary of the data source.

    Variables used in the analysis.

    The six steps of hypothesis testing.

    Prepare and submit the PowerPoint poster and summary as two separate documents.

    Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

    This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

    You are required to submit this assignment to LopesWrite. Refer to the
    LopesWrite Technical Support articles
    for assistance.

    Attachments

    PUB-550-RS-National-Health-Interview-Survey-Dataset.sav

    PUB-550-RS-Analyzing-and-Reporting-Data-Overview.docx

    PUT-550-RS-Demographhic-and-Health-Survey-Dataset.sav

    PUB-550-RS-Youth-Risk-Behavior-Surveillance-System-Dataset.sav

    PUB-550-RS-GCU-MPH-Poster-Template.pptx

    Analyzing and Reporting Data – Overview

    The purpose of this assignment is to give you experience conducting a basic secondary data analysis using real-world surveillance data. Secondary data analysis is faster and cheaper to conduct compared to primary data collection. However, there are also significant limitations. The data were likely collected for a different purpose, and may not include the specific variables required to answer your question. The sampling strategy might not be random and may not be representative of your target population. These are examples of such limitations you should be aware of as you work with existing data.

    A key question is whether the data should determine the research question, or if the research question should determine the type of data you use. In practice, you would want your research question or hypothesis to determine the dataset you select. In this assignment, you are limited to three datasets and may need to adjust your initial research question to accommodate one of the three datasets. Avoid “mining” for significant results and stick to your initial research question as much as possible. For this project, you will select one of the three example datasets to complete a basic analysis and communicate your findings through a scientific poster presentation. PUB-550: Application and Interpretation of Public Health Data

    These steps will help you get started:

    Review the websites for each of the three datasets listed below. Be sure to understand the purpose of the survey, the sample used in the survey, and the main focus areas of each survey. Review the documentation provided on the websites to get to know the story behind the data and understand the population before reviewing the data.

    Select the dataset that is most appropriate for your interest area.

    Open the data in SPSS and get to know the data by reviewing the variables in “Variable View” mode. This view will allow you to read the variable labels and response labels for each variable.

    Based on your research interest and question, select variables that will help increase your understanding about that topic.

    Arrange the data as needed to organize and clean data, allowing you to focus on your specific question. Remember to save your analytic data file as a new file in case you need to go back to the original file. It is good practice to continually save new versions of the data file as you work with and manipulate the data.

    Follow the hypothesis testing steps to carry out your secondary data analysis. PUB-550: Application and Interpretation of Public Health Data

    For additional information on conducting a secondary data analysis, read the Topic Material, “Conducting High-Value Secondary Dataset Analysis: An Introductory Guide and Resources.”

    Dataset Documents

    Demographic and Health Survey

    The Demographic and Health Survey is a global monitoring survey administered by USAID. The sample dataset is the model data set put together by USAID to explore DHS data. The sample data is not from a specific country or year, but it gives you an idea of what can be obtained from various countries through these datasets. The datasets are free and publically available once you register with USAID to access the DHS data. For the purpose of this assignment, treat this dataset as coming from a country of your choice. Access to the Model Questionnaire, Recode Manual, and Data Video Tutorials, including a video on the sampling strategy, is found at
    http://dhsprogram.com/data/model-datasets.cfm
    .

    Note:
    You do not need to worry about weighting strategies for this assignment.

    Use the
    http://dhsprogram.com/data/Using-DataSets-for-Analysis.cfm
    link to review the “
    Step-by-Step Introduction to Analyzing DHS Data”
    for tips on how to access your own dataset for future use and to see what resources are available to help you navigate the model dataset for this assignment:

    Youth Risk Behavior Surveillance System (YRBSS)

    The Youth Risk Behavior Survey is a national survey monitoring health behaviors among youth and young adults. It is administered by the Centers for Disease Control and Prevention. The example dataset for this assignment comes from the National Survey (not combined) dataset for 2015. General information about the survey is found at
    https://www.cdc.gov/healthyYouth/data/yrbs/index.htm
    .

    Documentation and questionnaires can be found by accessing the “YRBSS Data and Documentation: website at
    https://www.cdc.gov/healthyyouth/data/yrbs/data.htm
    . PUB-550: Application and Interpretation of Public Health Data

    Please read the
    2015 YRBS Data User’s Guide,
    listed in the “National YRBS Datasets and Documentation” page at
    https://www.cdc.gov/healthyyouth/data/yrbs/pdf/2015/2015_yrbs-data-users_guide_smy_combined.pdf
    .

    The dataset includes calculated variables not found in the questionnaire that you might find helpful in determining your analysis for this assignment. The crosswalk to match the questions with the dataset can be found by viewing the “YRBS Questionnaire Content – 1991-2017” found at
    https://www.cdc.gov/healthyyouth/data/yrbs/pdf/2017/yrbs_questionnaire_content_1991-2017.pdf
    .

    National Health Interview Survey (NHIS)

    The NHIS began in 1957, and has been used to monitor the health of the United States ever since. It is a household-level survey administered by the U.S. Census Bureau. Key topics in the survey include doctor’s visits, medical conditions, health insurance, and health behaviors. General information about the survey, including the sample design and data collection procedures, can be found at
    https://www.cdc.gov/nchs/nhis/about_nhis.htm
    .

    A
    Survey Description
    of the 2015 National Health Interview Survey can be found at
    ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NHIS/2015/srvydesc.pdf
    .

    The sample dataset is from the 2015 adult survey at
    https://www.cdc.gov/nchs/nhis/nhis_2015_data_release.htm
    .

    Some of the variables have been deleted to decrease the size of the file, but none of the observations have been dropped. Please review the “2015 National Health Interview Survey (NHIS) Public Use Data Release” document at
    ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NHIS/2015/readme.pdf
    .

    Review the “2015 NHIS Public Use Variable Summary” at
    ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NHIS/2015/samadult_summary.pdf
    .

    After you identify a few variables you are interested in, review the complete description of the variable in the variable layout document at
    ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NHIS/2015/samadult_layout.pdf
    .

    Checking the variable frequencies will help you determine the range of answers for each variable of interest, including the number of missing observations PUB-550: Application and Interpretation of Public Health Data. If the number missing is high, consider using another variable. Variable frequencies can be found at
    ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NHIS/2015/samadult_freq.pdf
    .

     

    Topic 8 DQ 1

    Reporting public health information requires a clear understanding of the various statistical methods used to draw conclusions. These methods are then communicated within the larger story surrounding the public health issue. Identify a public health report or article and discuss what you would do differently to improve understanding and application if you were the author. Post the permalink to your article or report in the Main Forum.

    BUY A PLAGIARISM-FREE PAPER HERE

    Topic 8 DQ 1

    The world today does not have a shortage of public health issues. Researchers are constantly gathering more data to develop prevention and protection programs. In order to properly accomplish this, it is necessary to have a clear understanding of statistical methods to draw accurate conclusions. It is possible to find statistics on nearly all public health issues, which is why is it critical for the scientists and professionals to have a grasp on all statistical methods available.

    One public health issue that is relevant today is obesity. The general population is aware that poor nutrition, lack of physical activity and obesity cause a number of health-related issues, however obesity is getting worse all over the world. An article that addresses the issue, published by the World Health Organization, is ‘Obesity and Overweight’. The link to the article is
    https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
    .

    Key facts from the article:

    Obesity has tripled worldwide since 1975

    In 2016, 1.9 million adults over the age of 18 were considered overweight; 650 million were obese

    40 million children under the age of 5 were overweight or obese. PUB-550: Application and Interpretation of Public Health Data.

    In 2016, over 340 million children and adolescents aged 5-19 were obese or overweight

    (WHO, 2020).

    The article references multiple statistics regarding population obesity. The article also defines obesity and overweight in order to understand what determines who falls into the obese category and who falls into the overweight category. WHO also shared recent global estimates:

    In 2016, more than 1.9 billion adults aged 18 years and older were overweight. Of these over 650 million adults were obese.

    In 2016, 39% of adults aged 18 years and over (39% of men and 40% of women) were overweight.

    Overall, about 13% of the world’s adult population (11% of men and 15% of women) were obese in 2016.

    The worldwide prevalence of obesity nearly tripled between 1975 and 2016

    (WHO, 2020).

    While the information is interesting and useful, it would be helpful for the reader if WHO discussed the application used to develop the statistical data. WHO also shared the cause and prevention tactics for obesity. It would be helpful if WHO developed predictions for the next five years if people followed obesity prevention guidelines verses if these guidelines were not followed; all while providing the method to creating the statistical data. This would help the reader to better understand the importance of the public health issue. The sample size and surveillance methods should also be shared regarding obesity data retrieval.

    Reference

    World Health Organization (WHO). (2020). Obesity and overweight. Retrieved from https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight PUB-550: Application and Interpretation of Public Health Data

  • NURS 6565 Week 3 Discussion Essay: Quality and Cost Measurements

    NURS 6565 Week 3 Discussion Essay: Quality and Cost Measurements

    Quality measures are important especially in the field of healthcare because it gives a direct and quantifiable measure of how well do the health systems provide care.

    Quality measures gives an exact and direct information while performance indicator provides indirect and interpretable data.

    Healthcare quality measures are based on reliable data and information that tells how good a health plan or program in terms of achieving their desired outcome. Without quality measures, there will be no direct way to measure whether or not a health program achieved its established goals

    The difference between the performance indicator and quality measures is that, quality measures are focused on the countable and defined values in relation with set goals, while performance indicator indicates a measure of accomplishments.

    ORDER A PLAGIARISM-FREE PAPER HERE

    NURS 6565 Week 3 Discussion: Quality and Cost Measurements

    NURS 6565 Week 3 Discussion: Quality and Cost Measurements – As nurse practitioners continue to expand their role in delivering health care, it is imperative for NPs to provide the data and evidence to demonstrate the impact of NP care on patient outcomes. There are several challenges that advanced practice nurses face to provide quality care and meet productivity goals of an organization. This week it is important to explore the connection of quality care and performance measures. NURS 6565 Week 3 Discussion Essay: Quality and Cost Measurements. Some questions to consider as we discuss this topic are:

    Why are quality measures important?

    What is the difference between quality measures and performance indicators?

    What performance measures are used for NP productivity?

    Why are incentive plans used in clinical organizations?

    To prepare FOR NURS 6565 Week 3 Discussion: Quality and Cost Measurements:

    Read the article, An Incentive Plan for Advanced Practice Registered Nurses: Impact on Provider and Organizational Outcomes, by Catherine A. Rhodes, Mavis Bechtle, and Molly McNett (2015)

    Explore quality measures and identify at least one clinical performance measure, such as the Agency for Healthcare Research and Quality (AHRQ)

    By Day 3 OF NURS 6565 Week 3 Discussion: Quality and Cost Measurements

    Post an explanation of the importance of quality measures using the clinical performance measure you identified as an example.

    Then, identify the performance measures used for NP productivity in Rhodes, Bechtle, and McNett (2015) article.

    Finally, share your opinion on incentive payment for care, including external motivators and at least one business model.

    NURS 6565 Week 3 Discussion: Quality and Cost Measurements Resources

    Buppert, C. (2015). Measuring Nurse Practitioner Performance. 
    In Nurse Practitioner’s Business Practice and Legal Guide
     (5th ed.) (469 – 478). Burlington, MA: Jones & Bartlett.

    This chapter will cover standards of care, and measures of nurse practitioner performance

    Hain, D., & Fleck, L. M. (2014). Barriers to NP practice that impact healthcare redesign. 
    OJIN: The Online Journal of Issues in Nursing, 19(2). NURS 6565 Week 3 Discussion Essay: Quality and Cost Measurements

    Note:
     Retrieved from the Walden Library databases.

    Rhodes, C. A., Bechtle, M., & McNett, M. (2015). An Incentive Plan for Advanced Practice Registered Nurses: Impact on Provider and Organizational Outcomes. 
    Nursing Economics, 33(3),
     125-131.

    Note:
     Retrieved from the Walden Library databases.

    Stanik-Hutt, J., Newhouse, R. P., White, K. M., Johantgen, M., Bass, E. B., Zangaro, G., . . . Weiner, J. P. (2013). The Quality and Effectiveness of Care Provided by Nurse Practitioners. 
    Journal for Nurse Practitioners,
     9(8), 492-500. doi:10.1016/j.nurpra.2013.07.004

    Note:
     Retrieved from the Walden Library databases.

    Thomas, A. C., Crabtree, M. K., Delaney, K. R., Dumas, M. A., Kleinpell, R., Logsdon, C.,…Nativio, D. G. (2012). 
    Nurse Practitioner Core Competencies. 
    Retrieved from http://c.ymcdn.com/sites/www.nonpf.org/resource/resmgr/competencies/npcorecompetenciesfinal2012.pdf

    Wilkinson, K. (2015). 
    Legal Nuts and Bolts for PNPs in Today s Healthcare Environment
    [PowerPoint slides]. Retrieved from http://docplayer.net/5760521-Legal-nuts-and-bolts-for-pnps-in-today-s-healthcare-environment-karen-wilkinson-mn-arnp-lnc-wilkinson-legal-nurse-consulting.html NURS 6565 Week 3 Discussion Essay: Quality and Cost Measurements

    NURS 6565 Week 3 Discussion: Quality and Cost Measurements

    Week 3 Discussion

    As nurse practitioners continue to expand their role in health care, it is important to provide the data and evidence to demonstrate the impact of NP care on patient outcomes. There are several challenges that advanced practice nurses face to provide quality care and meet productivity goals of an organization.  Quality measures seek to measure the degree to which evidence-based treatment guidelines are followed, where indicated, and assess the results of care. The use of quality measurement helps strengthen accountability and supports performance improvement initiatives at numerous levels.  The performance measures used in the article we read are quality, patient satisfaction, professional participation, and training. NURS 6565 Week 3 Discussion Essay: Quality and Cost Measurements.

    AANP and the National Nurse-Led Care Consortium (NNCC) are administering an NP SAN for the Transforming Clinical Practice Initiative (TCPi).  This is a new program supported by the Centers for Medicare & Medicaid Services (CMS). CMS offers several technical assistance programs to help clinicians successfully participate in one of the two payment tracks under the Quality Payment Program (QPP).

    The TCPi is a four-year technical assistance program designed to help clinicians expand their quality improvement capacity, engage in greater peer-to-peer learning and utilize health data to determine gaps and target intervention needs. The NP SAN promotes NP participation in this quality improvement initiative by providing free education, technical assistance and training and access to specialized evidenced-based tools. NPs in either nurse-led or physician-led health care settings are eligible to receive these program benefits (AANP, 2019).

    Incentive payments based on quality measurements is a common theme for health care providers. One model that is currently being used in Europe and Australia, an alternative payment model, bundles acute hospital care at home with 30 days of home bound post-acute care (Zolot, 2018) NURS 6565 Week 3 Discussion Essay: Quality and Cost Measurements. Patient satisfaction can be increased if they are able to have more control over their health care and providing care inside the home can help establish this.  The model also significantly reduced hospital readmission rate, visits to the emergency department, and risk of transfer to a skilled nursing facility (Zolot, 2018). Nurse practitioners will provide continuity of care on a daily basis as well. This model, when implemented, can increase patient satisfaction which could also help with reimbursement.

     

    Rhodes, C. A., Bechtle, M., & McNett, M. (2015). An Incentive Plan for Advanced Practice Registered Nurses: Impact on Provider and Organizational Outcomes. Nursing Economics, 33(3), 125-131.

    Zolot, Joan, PA, 2018. AJN The American Journal of Nursing: October 2018 – Volume 118 – Issue 10 – p 13doi: 10.1097/01.NAJ.0000546363.97759.db

    https://www.aanp.org/practice/practice-management/quality-improvement/nurse-practitioner-support-and-alignment-network-np-san

    NURS 6565 Week 3 Practicum Journal wk 3

    Each week you will complete a Practicum Journal entry and Time Log that prompts you to reflect on and document your Practicum Experiences.

    Practicum Journal

    Continue documenting your Practicum Experiences in your Practicum Journal. Reflect on your practicum experiences and relate them to your Professional Goals and Self-Assessment of Clinical Skills that you identified in Week 1.

    Follow journal entry format and choose any illness or patient…..

    E.g

    Reflect on a patient who presented with a disease. Describe key signs and symptoms that were consistent with this disease. If you diagnosed the patient with the disease, describe your experience in telling the patient that she had the disease, as well as the patient’s reaction to the diagnosis. Explain how the diagnosis might impact the patient’s life short-term and long-term. Include an explanation of the patient’s medical history, drug therapy and treatments, and follow-up care NURS 6565 Week 3 Discussion Essay: Quality and Cost Measurements. If you did not have an opportunity to evaluate a patient with this background during the last four weeks, you may select a related case study from a reputable source or reflect on previous clinical experiences.

    ORDER A PLAGIARISM-FREE PAPER HERE

    125NURSING ECONOMIC$/May-June 2015/Vol. 33/No. 3

    R ELATIVE VALUE UNITS (RVUs)are used within healthcare organizations to indi-cate resources re quired when determining physician fee schedules. While RVUs typically compose the core of physician fees and are often used in physician incentive plans, these units are not always utilized in advanced prac- tice registered nurse (APRN) mod- els. APRNs have become integral to the provision of quality, cost- effective health care throughout the continuum of care. As health care organizations respond to physician shortages and reim- bursement shifts, the number of APRNs is increasing rapidly, and finding a market advantage for hir- ing and retaining APRNs is imper- ative. Therefore, an innovative incentive plan for APRNs was cre- ated that incorporated both pro- ductivity and quality metrics. Data were gathered before and after

    implementation of this program to determine its effectiveness on pro – vider outcomes. The program and associated outcomes are des crib ed.

    Background Relative value units. RVUs

    reflect the relative resources required to furnish a physician fee schedule service. The Centers for Medicare & Medicaid Services (CMS) and other private insurers use the Medicare Physician Fee Schedule (MPFS) to reimburse physician services. The MPFS became effective January 1, 1992 and is funded by Part B. Three sep- arate RVUs are associated with the calculation of a payment und er the MPFS: work RVUs (wRVUs) reflect the relative time and intensity associated with providing a serv- ice and equals ap proximately 50% of the total payment; practice expense RVUs (reflect costs such as renting office space, buying sup-

    EXECUTIVE SUMMARY Advanced practice registered

    nurses (APRNs) are integral to the provision of quality, cost- effective health care throughout the continuum of care.

    To promote job satisfaction and ultimately decrease turnover, an APRN incentive plan based on productivity and quality was formulated NURS 6565 Week 3 Discussion Essay: Quality and Cost Measurements.

    Clinical productivity in the incentive plan was measured by national benchmarks for work relative value units for nonphysician providers.

    After the first year of implemen- tation, APRNs were paid more for additional productivity and quality and the institution had an increase in patient visits and charges.

    The incentive plan is a win-win for hospitals that employ APRNs.

    Catherine A. Rhodes Mavis Bechtle Molly McNett

    An Incentive Pay Plan for Advanced Practice Registered Nurses: Impact

    On Provider and Organizational Outcomes

    ACKNOWLEDGMENT: The authors ack – nowledge the support and guidance received from Jane Fusilero, MSN, MBA, RN, former vice president and chief nurs- ing officer of The MetroHealth System. The authors also acknowledge support from Dan Lewis, Vice President, Human Resources, The MetroHealth System, dur- ing implementation of this project.

    Instructions for Continuing Nursing Education Contact Hours appear on page 132.

    SERIES

    CATHERINE A. RHODES, MSN, APRN, WHNP-BC, RNC-OB, SANE-A, is Women’s Health Care Nurse Practitioner and Sexual Assault Nurse Examiner, The MetroHealth System, Cleveland, OH.

    MAVIS BECHTLE, MSN, RN, FACHE, is Vice President and Chief Nursing Officer, The MetroHealth System, Cleveland, OH.

    MOLLY McNETT, PhD, RN, CNRN, is Director, Nursing Research, The MetroHealth System, Cleveland, OH.

    NURSING ECONOMIC$/May-June 2015/Vol. 33/No. 3126 NURS 6565 Week 3 Discussion Essay: Quality and Cost Measurements

    plies and equipment, and staff); and malpractice RVUs (reflect the relative costs of purchasing mal- practice insurance and therefore varies by specialty) (CMS, 2012).

    A review of the literature fail – ed to yield descriptions of incen- tive-based programs for APRNs in a hospital setting based specifical- ly on wRVUs. However, within the current organization, a physician incentive plan based on wRVUs had been in place for several years. Physicians were given a default base salary of 90% of the total compensation benchmark. The adjusted base salary was then determined by average perform- ance relative to RVU benchmark for 2 previous calendar years. This model was not adopted for APRNs, however, as variations ex isted in scope of practice for APRNs in dif- ferent departments, and not all were billing providers. Therefore, productivity-based wRVUs would not be at the median benchmark for many of the APRNs, unfairly impacting their compensation.

    APRN incentive models. Pro – fit-sharing APRN incentive mod- els are described by Buppert (2006) and Kenny and Balzer (2010). These plans involve a per- centage of profits after cost and benefits paid from revenues. A contract between the APRN and the employer is involved in these models. The practice needs to be vetted and Buppert (2006) recom- mends that if collections in a prac- tice are less than 95% effective, the APRN should ask for a per- centage of the billings rather than the collections to ensure the APRN is incentivized appropriate- ly. This became the base of the model implemented within the organization. This organization is a county-subsidized hospital with a mission to care for all regardless of ability to pay. Therefore, the collection rate is much lower than the 40% described by Buppert (2006). This made full implemen- tation of the Buppert model diffi- cult and not attainable for most APRNs. Another separate incen-

    tive plan outlined by Buppert describes taking capitated fees received and dispensing based either by number of APRN visits or by panel size. This pertains to practices that are in a capitated reimbursement situation, and thus was not applicable to many areas of the institution NURS 6565 Week 3 Discussion Essay: Quality and Cost Measurements.

    The importance of including quality measures as well as pro- ductivity in APRN incentive plans

    has been discussed (Buppert, 2006, 2010; Chu, Wang, & Dai, 2009; Hofmann, 2009; Mackey, Rooney, & Skinner, 2009; Scott, 2009). Incorporation of incentive plans can increase quality, patient satisfaction, and provider job sat- isfaction (Challis, 2009; Duffin & Brannigan, 2008; McDonald, Harrison, & Checkland, 2008). While incentives can facilitate attracting, motivating, and retaining nurses (Mackey et

    NURS 6565 Week 3 Discussion: Quality and Cost Measurements

    Week 3 Discussion

    As nurse practitioners continue to expand their role in health care, it is important to provide the data and evidence to demonstrate the impact of NP care on patient outcomes. There are several challenges that advanced practice nurses face to provide quality care and meet productivity goals of an organization.  Quality measures seek to measure the degree to which evidence-based treatment guidelines are followed, where indicated, and assess the results of care. The use of quality measurement helps strengthen accountability and supports performance improvement initiatives at numerous levels.  The performance measures used in the article we read are quality, patient satisfaction, professional participation, and training.

    AANP and the National Nurse-Led Care Consortium (NNCC) are administering an NP SAN for the Transforming Clinical Practice Initiative (TCPi).  This is a new program supported by the Centers for Medicare & Medicaid Services (CMS). CMS offers several technical assistance programs to help clinicians successfully participate in one of the two payment tracks under the Quality Payment Program (QPP) NURS 6565 Week 3 Discussion Essay: Quality and Cost Measurements.

    The TCPi is a four-year technical assistance program designed to help clinicians expand their quality improvement capacity, engage in greater peer-to-peer learning and utilize health data to determine gaps and target intervention needs. The NP SAN promotes NP participation in this quality improvement initiative by providing free education, technical assistance and training and access to specialized evidenced-based tools. NURS 6565 Week 3 Discussion Essay: Quality and Cost Measurements. NPs in either nurse-led or physician-led health care settings are eligible to…

  • PUB-550 Data Management and Descriptive Statistics DQ Topics

    PUB-550 Data Management and Descriptive Statistics DQ Topics

    Topic 1: Data Management and Descriptive Statistics

    Objectives:

    Evaluate methods of data organization.

    Compare characteristics of correlational, experimental, and quasi-experimental (observational) statistics variables.

    Identify the four levels of measurement.

    Differentiate between a population and a sample, and a parameter and a statistic (descriptive and inferential).

    Explain the role of quantitative and qualitative methods and sciences in describing and assessing a population’s health.

    Evaluate public health data sources.

    Apply methods to calculate and communicate descriptive statistics.

    PUB-550 Data Management and Descriptive Statistics DQ Topics

    ORDER A PLAGIARISM-FREE PAPER HERE

    Topic 1 DQ 1

    Mixed methods research refers to an emergent methodology of research that advances the systematic integration or mixing of quantitative and qualitative data within a single investigation or sustained program of inquiry. The basic premise of this methodology is that such integration permits a more complete and synergistic utilization of data than do separate quantitative and qualitative data collection and analysis. It allows qualitative and quantitative research to complement each other. PUB-550 Data Management and Descriptive Statistics DQ Topics. It originated in the social sciences and has recently expanded into the health and medical sciences including fields such as nursing, family medicine, social work, mental health, pharmacy, allied health, and others (Wisdom & Creswell, 2013). Mixed method research can facilitate the involvement of other key stakeholders, such as partners, family members, and/or other knowledge users, in the process of developing the research question(s) and outlining the research designs. MMR is a strong option to leverage effective patient engagement and support ongoing research focused on patient-identified priorities and the improvement of patient outcomes (Regnault et al., 2018).

    Quantitative research is expressed in numbers and graphs. It is used to test or confirm theories and assumptions. This type of research can be used to establish generalizable facts about a topic. Requires many respondents, focuses on testing theories and hypotheses, and uses closed (multiple choice) questions. The Key terms for quantitative research are testing, measurement, objectivity, replicability (Streefkerk, 2019). PUB-550 Data Management and Descriptive Statistics DQ Topics

    Qualitative research is expressed in words. It is used to understand concepts, thoughts or experiences. This type of research enables you to gather in-depth insights on topics that are not well understood. It focuses on exploring ideas and formulating theory or hypothesis, it requires few respondents with open-ended questions. It is analyzed by summarizing, categorizing, and interpreting information. The key terms here are understanding, context, complexity, and subjectivity (Streefkerk, 2019). PUB-550 Data Management and Descriptive Statistics DQ Topics

     

    References:

    Streefkerk, R. (2019). The differences between quantitative and qualitative research. Retrieved from

    https://www.scribbr.com/methodology/qualitative-quantitative-research/

     

    Regnault, A., Willgoss, T., Barbic, S. (2018). Towards the use of mixed methods inquiry as best practice in health outcomes research. Retrieved from

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5934918/#__ffn_sectitle

     

    Wisdom, J. and Creswell, J. W. (2013). Mixed Methods: Integrating Quantitative and Qualitative Data Collection and Analysis While Studying Patient-Centered Medical Home Models. Retrieved from

    https://pcmh.ahrq.gov/page/mixed-methods-integrating-quantitative-and-qualitative-data-collection-and-analysis-while

     

     

    Topic 1 DQ 1

    Mixed methods research was originally designed for researching social sciences questions, however in recent years has expanded into the health and medical sciences research. Mixed method research combines the best parts of qualitative and quantitative research without the inevitable bias of each (Almaki, 2016). Qualitative research is non-numerical, scientific research involving observation, that is inductive and used by investigators to develop hypotheses (Wisdom & Creswell, 2013) PUB-550 Data Management and Descriptive Statistics DQ Topics. Inductive involves drawing meaning from those that are participating in the study. Qualitative falls victim to bias as it is difficult separate opinion or researcher bias with this method (Almaki, 2016). Quantitative on the other hand involves quantifiable numerical data used to test hypotheses. It is a deductive research method, meant to be used to collect data in regards to hypotheses developed investigating relationships between variables (Almaki, 2016). Mixed methods research allows for each qualitative and quantitative to make up for eachother’s weaknesses in integrating methodologies from both methods, allowing for greater understanding. According to Wisdom and Creswell (2013) the core characteristics of a well-designed mixed methods study is one that collects and analyzes both quantitative and qualitative data, uses rigorous procedures in process to ensure appropriate sample size for quantitative and qualitative analysis, integrates the data during data collection, analysis, and discussion, and implements both methods components either at the same time or sequentially. PUB-550 Data Management and Descriptive Statistics DQ Topics.

    There are different mixed methods designs that can be used by investigators, and which method is utilized may depend on the research question and resources available. There are explanatory, exploratory, embedded, and convergent (also referred to as triangulation). Explanatory occurs in two phases, an initial quantitative followed by qualitative data collection, allowing for quantitative results to be explained and understood through the personal experiences and explanation of qualitative data (Wisdom and Cresswell, 2013). This method is easy to apply, and allows for on type of data to complement and build on the other. Exploratory design is the reverse of explanatory as it collects qualitative data before quantitative. Qualitative data is collected through interviews and through analyzing the information an appropriate quantitative data collection can be performed (Alamaki, 2016). Embedded studies are augmentative studies, with one method playing a secondary role to the other PUB-550 Data Management and Descriptive Statistics DQ Topics. The benefits of embedded studies are that it is easier to implement and requires less resources, but there are challenges in integrating results (Alamaki, 2016). Triangulation, or convergent design, involves collecting both types of data at the same time on the same topic and then integrating for analysis and interpretation (Alamaki, 2016). The two types of data can compliment and validate one another, however it can be challenging to integrate two different methods.

     

    References

    Almalki, S. (2016). Integrating quantitative and qualitative data in mixed methods research-challenges and benefits. Journal of Education and Learning, 5(3), 288-296. doi: 10.5539/jel.v5n3p288

    Wisdom, J. & Creswell, J. W. (2013). Mixed methods: Integrating quantitative and qualitative data collection and analysis while studying patient-centered medical home models (AHRQ Publication No. 13-0028-EF). Retrieved from
    https://pcmh.ahrq.gov/page/mixed-methods-integrating-quantitative-and-qualitative-data-collection-and-analysis-while#h=Mixed%20methods 
      PUB-550 Data Management and Descriptive Statistics DQ Topics

     

    Topic 1 DQ 2

    Comprehending the foundation for hypothesis testing and other types of inferential statistics allows the individual to understand how both sample and population are different.

    Statistics(n.d.) study found the following: A population is a collection of people, items, or events about which you want to make inferences. It is not always convenient or possible to examine every member of an entire population. For example, it is not practical to count the bruises on all apples picked at an orchard. It is possible, however, to count the bruises on a set of apples taken from that population. This subset of the population is called a sample (p.n.d.) PUB-550 Data Management and Descriptive Statistics DQ Topics.

    However, when differentiating between Statistics and Parameter is both measure testing differently for example, Descriptive Statistics describe a sample whereas parameter describe an entire population.

    According to academy lessons (n.d.), an example of a descriptive statistic will be a pet shop that sells cats, dogs, birds and fish. If 100 pets are sold, and 40 out of the 100 were dogs, then one description of data on pets sold would be that 40% were dogs. However, in inferential statistics an example is wanting to know the height of all the men in a city with a population of millions of residents (p.n.d.) PUB-550 Data Management and Descriptive Statistics DQ Topics.

    According to Page (2014), Evidence‐based practice is supposed to affect clinical decision‐making, but interpreting research is often difficult for some clinicians. Clinical interpretation of research on treatment outcomes is important because of its influence on clinical decision‐making including patient safety and efficacy (p.726).

    Reference

    Page P. (2014). Beyond statistical significance: clinical interpretation of rehabilitation research literature.
    International journal of sports physical therapy
    ,
    9
    (5), 726–736.

    https://www.statisticshowto.datasciencecentral.com/how-to-tell-the-difference-between…

    https://study.com/academy/lesson/descriptive-and-inferential-statistics.html

     

    https://support.minitab.com/…/statistics/…statistics/…/how-are-population-and-sample-.

     

    Topic 1 DQ 2

    In a research study, participants are selected from a population, this is the larger group of cases a researcher is interested in studying (Corty, 2016). For example, a study researching exercise regimes uses all members from three local gyms. This would be the total population for the research study. Even after a specific population in a community is defined, it is impossible for the researcher to locate all subjects, for this reason, researchers conduct their research on a portion of the population, known as a sample (Corty, 2016). A sample is a small group of cases chosen within a population (Corty, 2016). It is called a representative sample if it accurately reflects the larger population (Corty, 2016) PUB-550 Data Management and Descriptive Statistics DQ Topics. Using the same example, the sample would be select members of both male and female adults for the exercise study.

    From a sample or population, a single number is formed such as an average. This number is used to summarize the group (Corty, 2016). It is known as a statistic if the number represents the sample and it is known as a parameter if the number represents a population (Corty, 2016). For example, if you wanted to know the mean income of the local community, it is a parameter of a population. When you draw a random sample of 200 community residents and determine the mean, that number would be a statistic. Most likely, you can conclude the population mean will be close to that same number PUB-550 Data Management and Descriptive Statistics DQ Topics.

    Descriptive statistics can be used to characterize a population or sample. It is a summary statement about of a set of cases (Corty, 2016). It involves reducing a set of data to a value (Corty, 2016). For example, if an individual reported 55% of the workplace is male, that would be a descriptive statistic. Inferential statistics can be used when describing the larger population (Corty, 2016). An inferential statistic also reduces data to a single value, but it is accomplished to make inferences about a population (Corty, 2016). This is why it is critical the sample represents the population. For example, you could stand in a mall and ask 200 people if they like shopping at a specific store. You then would use that information to reason that around 85% of people like shopping at that store. It is necessary to estimate parameters in inferential statistics. This means using a statistic from the same information and using it to for the population mean (Glen, 2014). PUB-550 Data Management and Descriptive Statistics DQ Topics.

    It is critical to be able to differentiate sample and population and parameter and a statistic in public health research. Public health is concerned with protecting the health of entire populations. These populations can be as small as a local neighborhood or as big as the entire world (CDC Foundation, 2020). In order to properly assess the health of big and small population, samples of populations must be drawn using specific parameters and statistics.

    References

    Centers for Disease Control and Prevention (CDC) Foundation. Public Health In Action. Retrieved from https://www.cdcfoundation.org/what-public-health

    Corty, E.W. (2016).
    Using and Interpreting Statistics: A Practical Text for the Behavioral, Social, and Health Sciences. (3
    rd
    Ed.)
    New York, NY: Worth Publishers

    Glen, S. (2014). What is Inferential Statistics? Retrieved from https://www.statisticshowto.datasciencecentral.com/inferential-statistics/ PUB-550 Data Management and Descriptive Statistics DQ Topics

  • Nurs 6565 Week 3 Board Vitals Exam questions with answers

    Nurs 6565 Week 3 Board Vitals Exam questions with answers

    Week 3 Nurs 6565N

    Board Vitals Exam

    A nurse practitioner enters a contract with a physician. What type of law governs this type of interaction?

    Administrative law

    Civil law

    Rules and regulations

    Criminal law

    A young nursing student is interviewing a nurse practitioner about her profession. Which of the following is true?

    The first nurse practitioners were family practitioners

    The first nurse practitioner program was started in 2001

    A nurse practitioner derives the legal right to practice from federal law

    NP practice is not regulated by the Department of Health and Human Services

    A nurse practitioner enters a contract with a physician. What branch of law governs this type of transaction?

    Administrative law

    Civil law

    Rules and regulations

    Criminal law

    What was the major impetus for the creation of the nurse practitioner role? Nurs 6565 Week 3 Board Vitals Exam questions with answers.

    Need for expert nurse clinician

    Shortage of primary care physicians

    Trend for specialized nurses to diagnose and manage unstable acute and chronic conditions

    Movement of graduate nursing education to diagnosis and treatment of major illnesses

    Who started the first nurse practitioner program?

    Hildegard Peplau

    Mary Breckenridge

    Agnes Mcgee

    Loretta Ford

    ORDER A PLAGIARISM-FREE PAPER HERE

    When the NP is paid directly by the patient’s payer who agrees to pay the NP for providing care for a specific population, this is called a:

    Contracted service system

    Second party system

    Third party system

    Fee for service system

    Which of the following practices constitutes a barrier to safe and effective healthcare

    Input from multiple team members

    Raising an objection about quality of care to a team member with a higher level of health profession education

    Use of informatics to inform team discussion

    Inadequate disclosure of errors to patients and families

    Nurs 6565 Week 3 Board Vitals Exam questions with answers

    An established patient agrees to pay the nurse practitioner directly for providing a specific service which is a

    Fee for service system

    Third party system

    Contracted service system

    Second party system

    A nurse practitioner is seeing patients in a clinic. Which of the following requirements must the NP meet to satisfy Medicare’s coverage requirements

    The services must be provided under direct supervision

    The services must be provided subject to restrictions and supervision requirements of the state

    The services must be billed through a clinic that is directed by a physician or through a hospital or health agency

    Services must be provided in a federally qualified health center (FQHC) or rural health clinic (RHC)

    When advocating for the profession of nursing, a nurse practitioner knows that responsibility for interrupting scope of practice parameters rests with which of the following Nurs 6565 Week 3 Board Vitals Exam questions with answers

    The state medical licensure board

    The state board of nursing

    The state legislature

    The individual NP

    The NP knows that his or her legal right to practice is derived from

    The laws of the state where he or she practices

    The nurse practice act of the state where he or she practices

    The federal medicare laws

    The board of nursing in the state where he or she practices

    Nurs 6565 Week 3 Board Vitals Exam questions with answers

    Your nursing license may be in jeopardy if

    You appropriately delegate medication administration to a trusted RN employee who administers a fatal dose

    You delegate client assessment tasks to an LPN who has been floated to your outpatient clinic for the day

    You provide nursing care services consistent with established standards of practice in your jurisdiction

    The medical assistant in your supervising physician’s office exceeds the scope of her authority but you take prompt action to correct the problem

    The NP delegates a task to an unlicensed person. The person(s) responsible for outcomes in this case is

    The NP

    The unlicensed person who performs the task

    Both the NP and the unlicensed person

    The physician responsible for the NP

    According to the institute of medicine which of the following defines healthcare performance

    How things are done now

    The efficiency and outcome of care by an organization including patient satisfaction

    Healthcare delivery system inputs

    Activities within a healthcare organization

    Which of the following is true of advanced practice registered nurses

    Half of the states in the US license Nurse practitioners

    Designated titles by which nurse practitioners are known vary by state

    Only two states currently require NPs be certified by a national certifying organization for nurses

    An APRN employed by the VA must have separate licenses for each state in which she works in a VA facility Nurs 6565 Week 3 Board Vitals Exam questions with answers

    Nonmaleficence is a principal ethic in nursing is best defined as

    Compassion; a desire to good

    Dedication, fairness, honesty, advocacy, and commitment to patients. It involves an agreement to keep promises and commitments based on the virtue of caring

    Avoidance of harm

    Equal and fair distribution of resources based on impartial analysis of benefits

    Which of the following characterizes the professional role of a nurse practitioner

    Nurse practitioners scope of practice does not reflect practice privileges allowed by certification

    Perspective authority is issued with NP certification

    Nurse practitioners can admit patients to hospitals in all states

    The scope of practice of a nurse practitioner reflects a full range of practice privileges allowed by certification and license

    The health insurance portability and accountability act

    Addresses the rights of the individual as they relate to privacy of health information

    Requires national standards for electronic health records

    Regulates transfer of health information needed for continuity of care

    All the above

    Which of the following scenarios is generally considered unethical. Nurs 6565 Week 3 Board Vitals Exam questions with answers.

    Having notes on a therapy patient, keeping them out of the medical record and denying the patient access to them.

    Charging patients a fee for missed appointments

    Hiring a patient to do lawn maintenance

    Declining a box of chocolates from a patient

    Which of the following is true of the title “nurse practitioner?”

    It can only be used by a nurse practitioner in active practice

    It indicates the patient has been certified by a non-governmental entity

    It is illegal for any person to use the title without a valid license

    It can be used by anyone who has met the educational requirements

    Nurs 6565 Week 3 Board Vitals Exam questions with answers

  • NRS-429 Family-Centered Health Promotion Essays

    NRS-429 Family-Centered Health Promotion Essays

    Family Health Assessment Part I

    Understanding family structure and style is essential to patient and family care. Conducting a family interview and needs assessment gathers information to identify strengths, as well as potential barriers to health. This information ultimately helps develop family-centered strategies for support and guidance.

    Health care for an individual is significant in determining how he or she maintains their overall personality. Assessment through correct parameters ensures proper evaluation and then subsequent solutions based on the same. Healthy family results in a healthy society, therefore the main objective of this assessment is to establish the health patterns of a family based in Melbourne, Australia.

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    Describe the family structure. Include individuals and any relevant attributes defining the family composition, race/ethnicity, social class, spirituality, and environment.

    Family structure

    For a family of 7 people including the parents of 40-45 years, the grandparents of 70-75 years and three children of 10, 13, and 17 years respectively. The family is a Caucasian one who follows Christianity and lives in their family-owned home in Kensington, Victoria the business district of Melbourne, Australia. The father is an accountant in a business organization and the mother teaches as a senior teacher in a school nearby. The children go to the same school and the grandparents are regular members of the community church and do voluntary and paid work for them from time to time. NRS-429 Family-Centered Health Promotion Essays. The family regularly visits their neighbours and has weekend hangouts with their friends (Lindblom, et.al 2017). The functional assessment of the health of few school children and adults has given the result that most of them face chronic pain while being differently-abled in either hand, feet or in other body parts (Kohls, Walker et. al, 2016).

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    Summarize the overall health behaviors of the family. Describe the current health of the family.

    Overall health behavior of the family

    As assessed from the interview questionnaire, and the responses, it could be observed that it is the mother who takes care of the health of all the family members. According to her, the children regularly have salads and homemade soup, and they are not allowed to have fast food. The grandparents go to a laughing club every weekend, but nowadays they are not going for the same. The father goes to work in the government labour department, and does not get much time for exercise. The mother teaches in a neighbourhood school, gets home by 5pm, and watches soap operas in television, while the father reads newspapers. NRS-429 Family-Centered Health Promotion Essays.

    Describe at least two of the functional health pattern strengths noted in the findings. Discuss three areas in which health problems or barriers to health were identified.

    Functional health strengths and health problems

    The two major functional health strengths of the family assessed here are regularly going for evening walks and regular intake of water, green vegetable, and fruits. The three major problem areas in health regarding this family are stress and anxiety situations have known to increase blood pressure and blood sugar levels suddenly. Children lead mostly an inactive lifestyle with most playing with video games and rarely taking part in any outdoor activity, therefore, they face pain in feet and hands due to the same reason (Kohls, Walker et. al, 2016).Women of the family suffer from breathing problems and get tired easily after doing household work. In addition to this, the children get seven to eight hours of sleep while the elders like the parents, and grandparents get five to six hours of sleep. The grandparents suffer from health issues like joint pain and high blood pressure. The parents have complaints of stress, depression, and anxiety due to work pressures and untimely food intake (Fang, Vincent et.al 2015). According to (Fang, Vincent et.al 2015), the assessment of the few adults suffering from sexually transmitted diseases like HIV/AIDS have given the results that these individuals are coping up with stress, anxiety, and depression with the support of their family, and peers.

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    Describe how family systems theory can be applied to solicit changes in family members that, in turn, initiate positive changes to the overall family functions over time.

    Family systems theory and application of the same

    The family systems theory describes the role of a family in an individual’s overall behavioral pattern. Through analyzing key concepts of this theory like emotional cut-off, sibling behavior, family problems, nuclear family issues, one would know how a family is functioning overall. For example, if someone in the family starts going for walks in the morning, he or she can influence other family members to do the same (Erdem & Safi, 2018). The effect of family on a child’s mental health is very significant. In the early years of the child, care giving, love, and warmth can prove positive in increasing emotional attachment and peer bonding. NRS-429 Family-Centered Health Promotion Essays.

    Conclusion

    While assessing the interview questionnaire regarding a family of seven people living in Victoria which is Melbourne, Australia it can be seen that the identity, relationship, and overall health behavior within the family is moderate. This family responds positively whereas in terms of coping with stress and anxiety, this family supports each other while also being critical of each other’s decisions. But the overall bonding in the family is good.

    Develop an interview questionnaire to be used in a family-focused functional assessment NRS-429 Family-Centered Health Promotion Essays. The questionnaire must include three open-ended, family-focused questions to assess functional health patterns for each of the following:

    Values/Health Perception

    2. Nutrition

    3. Sleep/Rest

    4. Elimination

    5. Activity/Exercise

    6. Cognitive

    7. Sensory-Perception

    8. Self-Perception

    9. Role Relationship

    10. Sexuality

    11. Coping

    Select a family, other than your own, and seek permission from the family to conduct an interview. Utilize the interview questions complied in your interview questionnaire to conduct a family-focused functional assessment. Document the responses as you conduct the interview.

    Family Health Assessment Questionnaire:

    Values/Health Perception

    1. Why you consider health as the most important aspect of your family?

    2. What is the family values regarding the health of the children?

    3. How does your social and medical conditions work parallel to each other?

    Nutrition

    1. Do you take nutritious food regularly?

    2. What kind of unhealthy food do you allow your children to have?

    3. What kind of special diet do you consider to fit the elderly?

    Sleep/Rest

    1. How many hours a day do you sleep? If less hour of sleeps why so?

    2. How far do you consider that you have the required amount of sleep?

    3. How far do you think the amount of rest you take is more than necessary?

    NRS-429 Family-Centered Health Promotion Essays

    Elimination

    1. How many times do you use the washroom in a day?

    2. How far do you consider elimination benefits your family?

    3. Do you have any issues regarding proper elimination?

    Activity/Exercise

    1. How many times a week do you work out? If less why?

    2. What kind of exercises do you like to do?

    3. Are you involved in any kind of sports? If not, why?

    Cognitive

    1. What are the obstacles you have faced while learning something?

    2. How many languages can you read/write?

    3. What are the languages that you speak excluding your mother tongue?

    Sensory-Perception

    1. How many times a month do you go for eye checkups?

    2. Do you suffer from any hearing problem? If so, why?

    3. Do you suffer from any breathing problem?

    Self-Perception

    1. What do you think about yourself as a person?

    2. What do you do when you are depressed?

    3. Do you have any doubt regarding your external appearance?

    Role Relationship

    1. How far do you think you are involved in the everyday dealings of the family?

    2. How do you consider the family as the most important aspect?

    3. How is your bonding with other family members?

    Sexuality

    1. How your religion bars you from any kind of sexual activity?

    2. Have you imparted any kind of sex education to your children?

    3. What are the methods of safe sex that you practice?

    Coping

    1. How do you cope with any kind of monetary crisis?

    2. How do you cope with any kind of medical emergency?

    3. How do you deal with any kind of personal crisis?

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